title: Survey of compartment syndrome of the lower extremity after gynecological operations.
abstract: OBJECTIVE
  This study was aimed to investigate incidence, circumstances and consequences of acute compartment syndrome (CS) of the lower extremity after gynecological operations in lithotomy position by collecting data from departments of Obstetrics and Gynecology in Germany.
  
  
  METHODS
  Retrospective observational study.
  
  
  METHODS
  Departments of Obstetrics and Gynecology in the area of North Rhine (Germany)
  
  
  METHODS
  A 24-item questionnaire was sent to 168 gynecological departments. In addition, cases anonymously reported to the Expert Committee for Medical Malpractice Claims of the Medical Association of North Rhine between 2002 and 2012 were analyzed.
  
  
  METHODS
  Incidence of acute CS after gynecological operations.
  
  
  RESULTS
  A total of 59 questionnaires (35 %) were returned for analysis, reporting 21 cases of CS. Based on the collected data, we calculated an incidence of postoperative CS ranging between 0.067 % and 0.28 %. All reported cases of postoperative CS occurred after surgeries in lithotomy position, 57.1 % of cases occurred after laparoscopic procedures and 76.2 % after procedures longer than 4 h. Overall, 61.0 % of departments do not routinely inform about the risk of this complication when they get patients' informed consent. Reported prevention strategies were inconsistent and ranged from none to multiple measures.
  
  
  CONCLUSIONS
  CS is a complication clearly associated with long lasting gynecological operations in Lithotomy position. Despite a relatively high incidence, so far no guidelines on perioperative management and medicolegal aspects exist and preventive measures are heterogeneous among institutions. The need for guidelines and recommendations by an expert committee has been identified.
authors: Department of Obstetrics and Gynecology, Ulm University, Ulm, Germany.
authors: Emanuel C A
authors: EC
authors: Bauer
authors: Nicolina
authors: N
authors: Koch
authors: Christoph J
authors: CJ
authors: Erichsen
authors: Tobias
authors: T
authors: Juettner
authors: Daniel
authors: D
authors: Rein
authors: Wolfgang
authors: W
authors: Janni
authors: Hans G
authors: HG
authors: Bender
authors: Markus C
authors: MC
authors: Fleisch
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D003161:Compartment Syndromes / Q000453:epidemiology*; D005260:Female; D005858:Germany; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000009:adverse effects; D035002:Lower Extremity; D008875:Middle Aged; D061646:Operative Time; D056888:Patient Positioning / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult