Surgery Extensive RPLND on 24/05/2013 - mass was densely adherent and required an arterial graft from aorta to the right iliac artery. Operating time 8 ½ hours EBL= 3,600mls Developed right leg ischemia in the recovery room & returned to theatre
Exploration of graft with popliteal & pedal embolectomy Significant amount of thrombus recovered Transferred to ICU
1 ST Day Post Op Developed right leg pain & reduced ankle movement. Possible compartment syndrome (increased pressure within a muscle compartment) Patients are at higher risk of compartment syndrome when a blood vessel is damaged & subsequently repaired through surgery.
Closure of medial fasciotomy & VAC dressing to lateral fasciotomy 27/05/13
Post Operative care MDT – nursing & medical staff, dietician, physiotherapy, Pain team, occupational health, discharge planning. PCEA TPN NPO, N/G, central line U/C Clips & tension sutures Heparin x 7 days then clexane 6/7 ICU Weight bear 3/7 post op Exercises - prevent foot drop Resting calf splint Mobilising frame 2/52 post op. Vac dressing x 15 days Occupational health home visit Discharged on 12/06/13
Discharge Convalescence x 1/52 Community physiotherapy 24/07/13 seen in clinic for histology results – no evidence of residual viable tumour. D/C from urology to oncology. October 2013 – resumed normal activity i.e. swimming & cycling. Continues to attend physiotherapy sessions.