Well leg compartment syndrome (WLCS) is a serious complication that occurs after prolonged surgery in the lithotomy position, but it is rare. We report a case of WLCS after laparoscopic lower anterior resection for rectal cancer. A 60s-year-old man with BMI 34.1 with a diagnosis of lower rectal cancer underwent laparoscopic lower anterior resection with lymph node D3 dissection (lateral lymph node dissection), and ileostomy in the lithotomy and Trendelenburg positions. The operation time was 10

more »

... hours and 38 minutes, and the amount of bleeding was 370 ml. Immediately after the operation, induration and tenderness of the left lower leg were observed. Examination the day after the operation revealed an increase in muscle-derived enzymes such as AST: 130U / L, LDH 360U / L, and CK 6548U / L, and diagnosed WLCS. There was no blood flow disorder or neuropathy, and the condition improved without any treatment such as fasciotomy. Although WLCS occurs infrequently, it may have a serious course and requires early diagnosis and early response. Preventive measures should be taken against complications due to intraoperative position, and if postoperative leg pain is present, the possibility of WLCS should be considered.