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Compartment syndrome after gynecologic laparoscopy: systematic review of the literature and establishment of normal values for postoperative serum creatine kinase and myoglobin levels

  • General Gynecology
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Abstract

Purpose

To evaluate published evidence in the literature on compartment syndrome (CS) in association with gynecologic surgery and to establish postoperative normal values for serum creatine kinase (CK) and myoglobin.

Methods

The present study consists of a case report of a patient with CS, a systematic review including 37 studies and 86 patients with CS, and a retrospective cohort study of 300 patients undergoing various types of laparoscopy for benign or malignant diseases in order to establish postoperative normal values.

Results

We report on a patient with early-stage ovarian cancer, who developed CS after laparoscopic surgery with massively elevated serum CK and myoglobin levels, i.e., 1109 U/L and 18151 µg/L, respectively. In our systematic review, median serum CK and myoglobin levels among women with CS were 19,223 (177–27,412) U/L and 1248 (285–1360) µg/L, respectively. In our cohort study, the median postoperative serum CK and myoglobin levels were 68 (14–1576) U/L and 45 (14–1040) µg/L, respectively. The 95th and 99th percentile of serum CK and myoglobin levels were 158 and 391.5 U/L, and 152.3 and 298.9 µg/L, respectively.

Conclusion

Markedly elevated postoperative serum levels of CK and myoglobin levels might raise the suspicion for CS and could therefore aid in the rapid diagnosis of CS.

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Author information

Authors and Affiliations

  1. Department of Internal Medicine I, Ordensklinikum Linz, Seilerstätte 4, 4020, Linz, Austria

    Katrin Hefler-Frischmuth

  2. Department of Gynecology, Ordensklinikum Linz, Linz, Austria

    Judith Lafleur, Gudrun Brunnmayr-Petkin, Franz Roithmeier, Verena Unterrichter & Lukas Hefler

  3. Karl Landsteiner Institute of Gynecologic Surgery and Oncology, Linz, Austria

    Lukas Hefler

  4. Department of Obstetrics and Gynecology, Ruhr University Bochum, Bochum, Germany

    Clemens Tempfer

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  1. Katrin Hefler-Frischmuth
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  2. Judith Lafleur
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Contributions

KH-F involved in protocol/project development, data collection and management, data analysis, and manuscript writing/editing. JL contributed to protocol/project development, data collection and management, and manuscript writing/editing. GB-P performed data collection and management and manuscript writing/editing. FR participated in protocol/project development and manuscript writing/editing. VU involved in data collection and management, data analysis, and manuscript writing/editing. LH and CT performed protocol/project development, data analysis, and manuscript writing/editing.

Corresponding author

Correspondence to Katrin Hefler-Frischmuth.

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Funding

No funding has been received for the present study.

Conflict of interest

All authors have no actual or potential conflict of interest including any financial, personal, or other relationships with other people or organizations within two years of beginning the submitted work that could inappropriately influence, or be perceived to influence, their work to disclose.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

IRB approval

IRB approval was obtained for the present study.

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Hefler-Frischmuth, K., Lafleur, J., Brunnmayr-Petkin, G. et al. Compartment syndrome after gynecologic laparoscopy: systematic review of the literature and establishment of normal values for postoperative serum creatine kinase and myoglobin levels. Arch Gynecol Obstet 296, 285–293 (2017). https://doi.org/10.1007/s00404-017-4440-7

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  • DOI: https://doi.org/10.1007/s00404-017-4440-7

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