Lithotomy position-related neurovascular complications in lower limbs after colorectal surgery: a review of the literature to streamline theprotocol for management: P059


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Abstract

Aim:To review the literature and streamline theprotocol for the management of lithotomy positionrelated neurovascular complications (PRNVCs) in lower limbs after colorectal surgery.Method:Electronic databases were searched to find relevant articles and a summary conclusion was generated.Results:PRNVCs afterprolonged lithotomy position in colorectal surgery can be classified into vascular, neurological, and neurovascular types. Among these, compartment syndrome (CS) is the most common and devastating morbidity. Seven case reports and 10 case series on 34 patients (27 males, six females) of CS in patients undergoing colorectal surgery were reported. The reported incidence was 1 in 3500. Mean age of patients was 35.5 years. In addition to lithotomy position of more than 4-5 hours, there were many otherpredisposing and aggravating factors. Earlier diagnosis by high clinical suspicion and management by compartmental decompression may potentially avoid the consequences of loss of limbs or life.Conclusion:In colorectal surgery, lower limb PRNVCs generally, and CS specifically, are unusual and rare, but they can give rise to limb-and life-threatening situations. A high index of clinical suspicion and early decompression may reduce morbidity. Preventive strategies should be designed and implemented, particularly in patients with multiplepredisposing and aggravating factors.

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