Fethi GÜLTOP, Nuray CAMGÖZ, Mehtap HONCA, Ahmet GEDİKLİ, Eyüp HORASANLI

İntraabdominal histerektomi sonrası lumbosakral pleksopati: olgu sunumu ve literatür taraması

Lumbosakral pleksus hasarı nadir görülen bir durumdur. Olguların çoğunda kendiliğinden veya tedavi ile zamanla iyileşme sağlamasına rağmen literatürde kalıcı hasar olan olgular da bildirilmiştir. Özellikle siyatik komponenti içeren hasarlar periferik sinir lezyonları ile karışabilmektedir. Erken dönemde yapılacak elektrodiagnostik testler anlamlı olmayabileceğinden abdominopelvik cerrahi geçiren hastalar postoperatif dönemde ayrıntılı nörolojik muayene ile değerlendirilmelidir.

Lumbosacral plexopathy after intraabdominal hysterectomy: a case report and review of literature

Lumbosacral plexus injury is a rare condition. Although most of the cases recover spontaneously or with treatment with time, patients with permanent damage have been reported in the literature. Damages, especially containing component of sciatic nerve, may be confused with peripheral lesions. Since electrodiagnostic tests may not be significant in the early period, patients undergoing abdominopelvic surgery should be evaluated with a detailed neurological examination in the postoperative period.

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1. Irvin W, Andersen W, Taylor P, Rice L. Minimizing the risk of neurologic injury in gynecologic surgery: Obstet Gynecol 2004;103(2):374-82.
2. Kehlet H, Jensen TS, Woolf CJ. Persistent postsurgical pain: risk factors and prevention. Lancet 2006;367(9522):1618-25.
3. Goldman JA, Feldberg D, Dicker D, Samuel N, Dekel A. Femoral neuropathy subsequent to abdominal hysterectomy: A comparative study. Eur J Obstet Gynecol Reprod Biol 1985;20(6):385-92.
4. Warner MA. Patient positioning and nerve injury: Anesthesiology Clinics of North America 1996;14(7):561-72.
5. Domínguez-Carrillo LG, González-Tamayo CA. Paralysis of the crural nerve as immediate complication of abdominal hysterectomy: Report of 14 cases. Ginecol Obstet Mex 1997;65: 430-2.
6. Dhillon SS, Sarac E, Lumbosacral plexopathy after dual kidney transplantation: Am J Kidney Disease 2000;36(5):1045-8.
7. Dyck PJ, Windebank AJ. Diabetic and nondiabetic lumbosacral radiculoplexus neuropathies: new insights into pathophysiology and treatment: Muscle Nevre 2002;25(4):477-91.
8. Chiou-Tan FY, Kemp K Jr, Elfenbaum M, Chan KT, Song J. Lumbosacral Plexopathy in gunshot wounds and motor vehicle accidents: Am J Phys Med Rehabil 2001;80: 280-5.
9. Pettigrew LC, Glass JP, Maor M, Zornoza J. Diagnosis and treatment of lumbosacral plexopathies in patients with cancer: Arch Neurol 1984;41(12):1282-5.
10. van Alfen N, van Engelen BG. Lumbosacral plexus neuropathy: a case report and review of the literature: Clin Neurol Neurosurg 1997;99(2):138-41.
11. Yee T. Recurrent idiopathic lumbosacral plexopathy: Muscle Nevre 2000;23(9):1439-42.
12. Kvist-Poulsen H, Borel J. Iatrogenic femoral neuropathy subsequent to abdominal hysterectomy: incidence and prevention. Obstet Gynecol 1982;60: 516-20.
13. Barbosa JS, Rabello RP, Saraiva RA, Vieira ZG, Rossi AMC. Lesão de nervo periférico nem sempre é complicação da anestesia regional: Rev Bras Anestesiol 1992;42: 239-42.
14. Bohrer JC, Walters MD, Park A, Polston D, Barber MD. Pelvic nerve injury following gynecologic surgery: a prospective cohort study: Am J Obstet Gynecol 2009;201(5):531.e1-7.
15. Marnie BW, Chad MB, Terrence DW, Kevin KT, Amy MS, Pankaj G et al. Perioperative Peripheral Nerve Injuries: Anesthesiology 2009;111: 490-7.
16. Amaral JLG, Rodrigues RC. Anestesia de membro inferior: Rev Bras Anestesiol 1995;45: 134-42.
17. Mulroy MF. Bloqueio de Nervos Periféricos. in: Barash PG, Cullen BF, Stoelting RK, editors. 1st ed. Anestesia Clinica. São Paulo, Manole 2004;715-42.
18. Gloviczki P, Cross SA, Stanson AW, Carmichael SW, Bower TC, Pairolero PC, et al. Ischemic injury to the spinal cord or lumbosacral plexus after aorto-iliac reconstruction: Am J Surg 1991;162: 131–6.
19. Dillavou ED, Anderson LR, Bernert RA, Mularski RA, Hunter GC, Fiser SM, et al. Lower extremity iatrogenic nerve injury due to compression during intraabdominal surgery: Am J Surg 1997;173(6):504-8.
20. McDaniel GC, Kirkley WH, Gilbert JC. Femoral nerve injury associated with the Pfannenstiel incision and abdominal retractors: Am J Obstet Gynecol 1963;87(3):381-5.
21. Brasch RC, Bufo AJ, Kreienberg PF, Johnson GP. Femoral neuropathy secondary to the use of a self-retaining retractor: report of three cases and review of the literature. Dis Colon Rectum 1995;38(10):1115-8.
22. Sinclair RH, Pratt JH. Femoral neuropathy after pelvic operation. Am J Obstet Gynecol 1972;112:404-7.
23. Hsieh LF, Liaw ES, Cheng HY, Hong CZ. Bilateral femoral neuropathy after vaginal hysterectomy: Arch Phys Med Rehabil 1998;79(8): 1018-21.
24. Chan JK, Manetta A. Prevention of femoral nerve injuries in gynecologic surgery: Am J Obstet Gynecol 2002;186(1):1-7.
25. Hopper CL, Baker JB. Bilateral femoral neuropathy complicating vaginal hysterectomy: analysis of contributing factors in 3 patients. Obstet Gynecol 1968;32: 543-7.
26. Schafhalter-Zoppoth I, Zeitz ID, Gray AT. Inadvertent femoral nerve impalement and intraneural injection visualized by ultrasound: Anesth Analg 2004;99(2):627-8.
27. Klein SM, D'Ercole F, Greengrass RA, Warner DS. Enoxaparin associated with psoas hematoma and lumbar plexopathy after lumbar plexus block: Anesthesiology 1997;87(6): 1576-9.
28. Aveline C, Bonnet F. Delayed retroperitoneal haematoma after failed lumbar plexus block: Br J Anaesth 2004;93(4):589-91.
29. American Society of Anesthesiologists, Task Force on the Prevention of Perioperative Neuropathies. Practice guidelines for the prevention of perioperative neuropathies: Anesthesiology 2000;92:1168- 1182.
30. Sumner A, Parry G, England SD. Traumatic nerve injuries: Am Acad Neuro Ann Semin 1994;11:1-18.
31. Brantigan JW, Owens ML, Moody FG. Femoral neuropathy complicating anticoagulant therapy: Am J Surg 1976;132(1):108-9.
32. Busis NA. Femoral and obturator neuropathies: Neurol Clin 1999;17(3):633-53.
33. Burnett AL, Brendler CB. Femoral neuropathy following major pelvic surgery: etiology and prevention. J Urol 1994;151(1): 163-5.
34. Alsever JD. Lumbosacral plexopathy after gynecologic surgery: case report and review of the literature: Am J Obstet Gynecol 1996;174(6): 1769-77.
35. Awerbuch GI, Nigro MA, Sandyk R, Levin JR. Relapsing lumbosacral plexus neuropathy: Eur neurol 1991;31(6):348-51.