腹腔鏡下前立腺全摘除術後に認められた総腓骨神経麻痺の1例

A case of common peroneal nerve palsy after laparoscopic radical prostatectomy

　症例は69歳，男性。検診でPSA高値を指摘され当科を受診した。T1C前立腺癌の診断下，開脚仰臥位にて腹腔鏡下前立腺全摘除術が施行された。術翌々日歩行を開始したところ両下肢の下垂がみられ，精査で総腓骨神経麻痺と判明した。ビタミンB₁₂内服，理学療法により症状は消失し，神経伝達速度でも改善が認められた。麻痺の発症機転として，長時間の下肢過伸展および外旋，気腹や頭低位による下肢の血流障害が考えられた。

A 69-year-old man with elevated PSA level was referred to our hospital and under the diagnosis of T1C prostate cancer, laparoscopic prostatectomy was per-formed in the supine position. Surgery time was about ten hours. On the second postoperative day, the patient complained of bilateral footdrops. The examination revealed common peroneal nerve palsy. The symptoms disappeared by the administration of vitamin B₁₂ and physiotherapy during the next 42 days. Hyperextension and circulatory disturbance of the legs during long-time surgery seemed to be the cause of the onset of the palsy.