Minimally Invasive Fasciotomy in Chronic Exertional Compartment Syndrome and Fascial Hernias of the Anterior Lower Leg: Short- and Long-Term Results

AbstractExercise-induced lower leg pain may be caused by chronic exertional compartment syndrome (CECS). Anterior or deep posterior compartments are usually affected. Knowledge about CECS of the lateral compartment (lat-CECS) is limited and outcome after fasciotomy is unknown. The purpose of this study is to report on success rates of fasciotomy in patients with lat-CECS. Surgical success rates in patients with lat-CECS diagnosed with a dynamic intracompartmental pressure (ICP) measurement were studied using a questionnaire (success: excellent or good as judged by the patient; unsuccessful: moderate, fair or poor). We conducted ICP measurements in 247 patients for suspected lat-CECS, of whom 78 were positively diagnosed. Following exclusion (n=11), 30 of the eligible 67 patients completed the questionnaire. Bilateral (70%, n=21/30) exertional pain (97%, n=29) and a feeling of tightness (93%, n=28) were the most frequently reported symptoms. Four years after fasciotomy, severity and frequency of symptoms had dropped significantly. Long-term surgical success was reported by 33% (n=10; excellent n=4, good n=6). Seventy-three percent (n=22) had resumed sports activities (9 same level, 13 lower level). In conclusion, a fasciotomy for lat-CECS was successful in the long term in just one of three operated patients in this retrospective study.

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Long term functional outcomes after minimally invasive surgical decompression in upper limb chronic exertional compartment syndrome in 30 patients

Hand Surgery and Rehabilitation ◽

10.1016/j.hansur.2020.09.006 ◽

2020 ◽

Author(s):

I. Guerzider Regas ◽

I. Pluvy ◽

P. Tuphe ◽

F. Sakek ◽

B. Fuchs ◽

...

Keyword(s):

Minimally Invasive ◽

Compartment Syndrome ◽

Upper Limb ◽

Functional Outcomes ◽

Surgical Decompression ◽

Chronic Exertional Compartment Syndrome ◽

Minimally Invasive Surgical ◽

Exertional Compartment Syndrome

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Assessing Long-Term Outcomes in Individuals Undergoing Fasciotomy for Chronic Exertional Compartment Syndrome of the Lower Leg (SS-44)

Arthroscopy The Journal of Arthroscopic and Related Surgery ◽

10.1016/j.arthro.2013.03.051 ◽

2013 ◽

Vol 29 (6) ◽

pp. e21-e22

Author(s):

Kevin Willits ◽

Nicholas Pasic ◽

Dianne Bryant

Keyword(s):

Compartment Syndrome ◽

Lower Leg ◽

Long Term Outcomes ◽

Chronic Exertional Compartment Syndrome ◽

Exertional Compartment Syndrome

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Long-term Results of Surgical Decompression of Chronic Exertional Compartment Syndrome of the Forearm in Motocross Racers

The American Journal of Sports Medicine ◽

10.1177/0363546511425647 ◽

2011 ◽

Vol 40 (2) ◽

pp. 452-458 ◽

Cited By ~ 25

Author(s):

Michiel B. Winkes ◽

Ernest J.T. Luiten ◽

Wart J.F. van Zoest ◽

Harm A. Sala ◽

Adwin R. Hoogeveen ◽

...

Keyword(s):

Compartment Syndrome ◽

Surgical Decompression ◽

Long Term Results ◽

Chronic Exertional Compartment Syndrome ◽

Exertional Compartment Syndrome

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Factors Predicting Lower Leg Chronic Exertional Compartment Syndrome in a Large Population

International Journal of Sports Medicine ◽

10.1055/s-0043-119225 ◽

2017 ◽

Vol 39 (01) ◽

pp. 58-66 ◽

Cited By ~ 14

Author(s):

Johan de Bruijn ◽

Aniek van Zantvoort ◽

David van Klaveren ◽

Michiel Winkes ◽

Marike van der Cruijsen-Raaijmakers ◽

...

Keyword(s):

Compartment Syndrome ◽

Predictive Model ◽

Pressure Measurement ◽

Large Population ◽

Lower Leg ◽

Leg Pain ◽

Intracompartmental Pressure ◽

Discriminative Ability ◽

Chronic Exertional Compartment Syndrome ◽

Exertional Compartment Syndrome

AbstractKnowledge about lower leg chronic exertional compartment syndrome (CECS) is largely obtained from highly selected populations. Patient characteristics may therefore not be appropriate for the general population. Our purpose was to describe a heterogeneous population of individuals suspected of lower leg CECS and to identify predictors of CECS. Charts of individuals who were analyzed for exercise-induced lower leg pain in a referral center between 2001 and 2013 were retrospectively studied. Patients were included if history and physical examination were suggestive of CECS and if they had undergone a dynamic intracompartmental pressure measurement. Six hundred ninety-eight of 1411 individuals were diagnosed with CECS in one or more of three lower leg muscle compartments (anterior tibial, deep flexor, lateral). Prevalence of CECS peaked around the age of 20–25 years and decreased thereafter, although a plateau around 50 years was found. Age, gender, bilateral symptoms, previous lower leg pathology, sports (running and skating) and tender muscle compartments were identified as independent predictors of lower leg CECS. The proposed predictive model has moderate discriminative ability (AUC 0.66) and good calibration over the complete range of predicted probabilities. The predictive model, displayed as a nomogram, may aid in selecting individuals requiring an invasive dynamic intracompartmental muscle pressure measurement.

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Short- and long-term outcomes in patients operated with total minimally invasive esophagectomy for esophageal cancer

Diseases of the Esophagus ◽

10.1093/dote/doab061 ◽

2021 ◽

Author(s):

Tobias Hauge ◽

Dag T Førland ◽

Hans-Olaf Johannessen ◽

Egil Johnson

Keyword(s):

Overall Survival ◽

Esophageal Cancer ◽

Minimally Invasive ◽

Minimally Invasive Esophagectomy ◽

University Hospital ◽

Long Term Results ◽

Resection Margins ◽

Invasive Esophagectomy ◽

Short And Long Term

Summary At our hospital, the main treatment for resectable esophageal cancer (EC) has since 2013 been total minimally invasive esophagectomy (TMIE). The aim of this study was to present the short- and long-term results in patients operated with TMIE. This cross-sectional study includes all patients scheduled for TMIE from June 2013 to January 2016 at Oslo University Hospital. Data on morbidity, mortality, and survival were retrospectively collected from the patient administration system and the Norwegian Cause of Death Registry. Long-term postoperative health-related quality of life (HRQL) and level of dysphagia were assessed by patients completing the following questionaries: EORTC QLQ-OG25, QLQ-C30, and the Ogilvie grading scale. A total of 123 patients were included in this study with a median follow-up time of 58 months (1–88 months). 85% had adenocarcinoma, 15% squamous cell carcinoma. Seventeen patients (14%) had T1N0M0, 68 (55%) T2-T3N0M0, or T1-T2N1M0 and 38 (31%) had either T3N1M0 or T4anyNM0. Ninety-eight patients (80%) received neoadjuvant (radio)chemotherapy and 104 (85%) had R0 resection. Anastomotic leak rate and 90-days mortality were 14% and 2%, respectively. The 5-year overall survival was 53%. Patients with tumor free resection margins of >1 mm (R0) had a 5-year survival of 57%. Median 60 months (range 49–80) postoperatively the main symptoms reducing HRQL were anxiety, chough, insomnia, and reflux. Median Ogilvie score was 0 (0–1). In this study, we report relatively low mortality and good overall survival after TMIE for EC. Moreover, key symptoms reducing long-term HRQL were identified.

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