Chirurgia最新文献

{"title":"Primary Fallopian Tube Carcinoma: Clinicopathological Characteristics, Therapeutic Management and Prognostic Factors in a Cohort of 72 Patients.","authors":"Mihaela-Mădălina Gavrilescu, Viorel Scripcariu, Bogdan Filip, Maria-Gabriela Aniţei, Nicolae Ioanid, Dragoş-Viorel Scripcariu, Ana Grigoraş, Ionuţ Huţanu","doi":"10.21614/chirurgia.3303","DOIUrl":"https://doi.org/10.21614/chirurgia.3303","url":null,"abstract":"<p><p><b>Background:</b> Primary fallopian tube carcinoma is a rare gynecologic malignancy with clinical and biological features overlapping epithelial ovarian cancer. Due to its low incidence, data regarding prognostic factors and optimal therapeutic strategies remain limited. <b>Methods:</b> This retrospective study included patients who underwent surgical treatment for primary fallopian tube carcinoma between 2014 and 2025 at the First Oncological Surgery Unit of a tertiary cancer institute. Clinicopathological characteristics, treatment patterns, and survival outcomes were evaluated. Univariate and multivariate Cox regression models were used to identify prognostic factors. <b>Results:</b> Seventy-two patients were included in our study. Advanced-stage disease predominated, with FIGO stage IIIâIV identified in the majority of cases. Neoadjuvant chemotherapy was administered to 33.3% of patients, while 95.8% received adjuvant chemotherapy. Complete cytoreduction was achieved in 75% of patients. On multivariate analysis, the use of neoadjuvant chemotherapy was associated with poorer survival (p=0.042). Bilateral salpingo-oophorectomy was associated with improved survival (p=0.031), while FIGO stage approached statistical significance. <b>Conclusions:</b> Primary fallopian tube carcinoma frequently presents at an advanced stage and requires complex multimodal management. Despite advances in molecular profiling and surgical techniques, early detection remains elusive due to the subtle and non-specific nature of symptoms and the anatomical inaccessibility of the fallopian tubes.</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":"121 3","pages":"249-259"},"PeriodicalIF":1.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Options in the Treatment of Rectal Cancer: A Systematic Review and Meta-Analysis.","authors":"Alain David Medina, Marius Alexandru Moga, Oscar Diaz Pi, Anda Hogea, Catalin Misarca, Mircea Hogea","doi":"10.21614/chirurgia.3157","DOIUrl":"10.21614/chirurgia.3157","url":null,"abstract":"<p><p><b>Background:</b> Rectal surgery has evolved through the combined efforts of anatomists and surgeons. Minimally invasive surgery has gained recognition over open surgery due to fewer perioperative complications, and faster postoperative recovery. <b>Methods:</b> A systematic search was conducted in PubMed, Scopus, and Web of Science to identify studies published between 2014 and December 2024 comparing laparoscopic surgery (LS) and open surgery (OS) for rectal cancer. Primary outcomes included postoperative complications, number of lymph nodes harvested, overall survival, and disease-free survival. <b>Results:</b> Eight randomized controlled trials and one non-randomized study, including a total of 3,935 patients, were analyzed. LS showed a lower incidence of postoperative complications [OR: 0.64; 95% CI, 0.53, 0.77; p=0.008] and a slight advantage in lymph node harvest (WMD: 0.66; 95% CI: -0.63â?\"1.95). No significant differences were found in overall or disease-free survival. <b>Conclusions:</b> LS is a safe and effective option for rectal cancer treatment, offering better postoperative recovery and efficient lymph node retrieval, while maintaining long-term oncological outcomes comparable to OS.</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":"121 3","pages":"337-347"},"PeriodicalIF":1.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolomic Profiling of Plasma Bile Acids in Resectable Gastric Cancer.","authors":"Ștefan Ursu, Răzvan Alexandru Ciocan, Cristina-Paula Ursu, Radu-Cristian Moldovan, Florin Zaharie, Zeno Spârchez, Tudor Moisoiu, Alexandra-Iulia Bărăian, Rodica Sorina Pop, Cătălin Ioan Bodea, Cristina-Adela Iuga, Claudia Diana Gherman, Nadim Al Hajjar","doi":"10.21614/chirurgia.3314","DOIUrl":"10.21614/chirurgia.3314","url":null,"abstract":"<p><p><b>Background:</b> Gastric cancer (GC) is characterized by late-stage diagnosis and a lack of reliable non-invasive biomarkers. This study aims to investigate the plasma bile acid (BA) profile to enhance the understanding of GC metabolism and identify potential diagnostic and prognostic tools. <b>Methods:</b> In a case-control design, 62 GC patients (stages I III) and 70 matched controls were recruited. Using liquid chromatography-tandem mass spectrometry (LC-MS/MS), the concentrations of 48 metabolites in plasma were measured. Statistical analysis included univariate tests, principal component analysis, and linear discriminant analysis (LDA). <b>Results:</b> GC patients showed a significantly lower CA/CDCA ratio and alterations in secondary and conjugated bile acids, including TLCA, GLCA, TDCA, GDCA, and GUDCA, suggesting involvement of the gut liver microbiome axis. The ability to distinguish between groups was moderate (AUC = 0.731). Furthermore, BA levels were negatively correlated with tumor stage, tumor size, and systemic inflammatory markers (CRP, mGPS), while they were positively correlated with nutritional and hematological markers such as albumin and hemoglobin. <b>Conclusions:</b> Gastric cancer is associated with a distinct circulating BA profile that reflects not only tumor-related metabolic remodeling, but also systemic inflammation, nutritional status, and disease burden. The reduced CA/CDCA ratio and alterations in secondary and conjugated bile acids support the involvement of the gut-liver-microbiome axis in GC biology. Although BA profiling alone showed moderate diagnostic performance, its integration with conventional tumor markers, inflammatory indices, and clinico-pathological parameters may improve multimodal biomarker panels for noninvasive patient stratification, disease assessment, and future prognostic evaluation.</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":"121 Ahead of print","pages":"aop"},"PeriodicalIF":1.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148276269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiotoxicity Associated with Antineoplastic Therapy: A Multidisciplinary Approach to Personalized Monitoring Using Radionuclide Imaging and Molecular Biomarkers.","authors":"Lidia Anca Kajanto, Dana Lucia Stănculeanu, Anita-Cristina Ionescu, Ioan Sã Rbu, Ion Alexandru Popovici, Ionuţ Bulbuc, Mihaela Pundiche, Ileana-Delia Manea-Sabău, Andreea Diana Kajanto, Bogdan Caraban","doi":"10.21614/chirurgia.3310","DOIUrl":"10.21614/chirurgia.3310","url":null,"abstract":"<p><p><b>Background:</b> Cardiotoxicity associated with antineoplastic therapy may compromise both cardiovascular outcomes and continuity of cancer treatment. We evaluated a multimodal strategy based on radionuclide imaging and molecular biomarkers for early detection of subclinical cardiac dysfunction and for personalized monitoring applicable in multidisciplinary oncologic care. Methodology: In this prospective, observational, single-center study, 90 adults with breast cancer, lymphoma, or lung cancer receiving potentially cardiotoxic regimens were evaluated at baseline (T0), after 3-4 cycles (T1), at treatment completion (T2), and at 6-month follow-up (T3). Antineoplastic exposure was classified according to dominant cardiotoxic profile, including anthracycline-containing regimens, anti-HER2 therapy, platinum/taxane-based chemotherapy, immunotherapy, and targeted agents when used. Monitoring included clinical assessment, ECG, MUGA/gated SPECT, echocardiography with LVEF and GLS, and serial hs-Tn, NT-proBNP, and sST2. <b>Results:</b> Median age was 56 years, and 62% of patients were women. Mean baseline LVEF was 60Ã+-5% and mean GLS â? '19.5Ã+-2.1%. During treatment, hs-Tn, NT-proBNP, and sST2 increased progressively, while LVEF declined to 57Ã+-6% and GLS to â? '16.6Ã+-2.5% at treatment completion. Imaging-defined cardiac dysfunction occurred in 30% of patients, including overt cardiotoxicity in 10%. Changes in hs-Tn correlated most strongly with GLS (r=â? '0.42, p=0.002). The integrated model showed the best predictive performance (AUC 0.91). <b>Conclusions:</b> Beyond diagnostic value, this multimodal model may support multidisciplinary decision-making in surgical oncology by identifying patients who require intensified surveillance, early cardioprotection, preoperative optimization, or adjustment of treatment sequencing. The findings should be interpreted as clinically promising and hypothesis-generating, requiring multicenter validation before routine implementation.</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":"121 3","pages":"328-336"},"PeriodicalIF":1.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum to Abdominal Wall Reconstruction Performing Posterior Component Separation without Transversus Abdominis Release, for a Complex Incisional Hernia (M2W1, L3W2 left) after TRAM Flap Breast Reconstruction (with video).","authors":"Cucu Diana Teodora, Radu Victor G","doi":"10.21614/chirurgia.3352","DOIUrl":"https://doi.org/10.21614/chirurgia.3352","url":null,"abstract":"<p><p>In the originally published version of the article, the author Diana Teodora Cucu omitted the affiliation for PhD Student al Carol Davila University of Medicine and Pharmacy, Bucharest, Romania. Below is the updated list of authors and corresponding affiliations: Diana Teodora Cucu (1), Victor Gheorghe Radu (2) 1 Center of Hernia Surgery, Life Memorial Hospital, Bucharest, Romania 2 PhD Student al Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":"121 ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147970887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic Surgery: Patient Benefits and Surgeon Challenges. A Systematic Literature Review and Narrative Synthesis.","authors":"Aaliyah Abimbola, Gabriella Quiney, Nachiket Joshi, Gianluca Colucci","doi":"10.21614/chirurgia.3302","DOIUrl":"10.21614/chirurgia.3302","url":null,"abstract":"<p><p><b>Background:</b> Since the 1990s, laparoscopic surgery has revolutionised surgical practice by enabling smaller incisions, faster recovery, and reduced postoperative complications. However, musculo-skeletal (MSK) injuries among surgeons - across open, laparoscopic, and robotic modalities - remain an under recognised occupational hazard. This review examines the causes, prevalence, and prevention strategies for MSK injuries in laparoscopic surgeons. <b>Methods:</b> A systematic literature review and narrative synthesis was conducted in accordance with PRISMA guidelines. Searches were performed in MEDLINE, Embase, and PubMed between August 2022 and March 2023 using PICO-derived terms. Inclusion criteria encompassed English-language studies published within the last decade focusing on MSK injuries in surgeons performing minimally invasive surgery (MIS). <b>Results:</b> From 321 screened publications, 43 studies met inclusion criteria. The neck, back, and shoulders were the most frequently affected regions. Contributing factors included sustained non-neutral postures, non-adjustable or poorly designed surgical equipment, and lack of ergonomic training. MSK injuries led to decreased productivity, burnout, and in some cases, surgical absenteeism. <b>Conclusion:</b> Preventive strategies- such as ergonomic education, equipment redesign, microbreaks, and strength training - can significantly reduce MSK injury risk among laparoscopic surgeons. Integration of ergonomics into surgical curricular and workplace design is crucial to protect surgeon wellbeing, ensure sustainable practice, and maintain high-quality patient care.</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":"121 Ahead of print","pages":"1-11"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148013925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum to Laparoscopic Pancreaticoduodenectomy - Initial Experience in a Hepatopancreatobiliary High-Volume Center.","authors":"","doi":"10.21614/chirurgia.3351","DOIUrl":"10.21614/chirurgia.3351","url":null,"abstract":"<p><p>In the originally published version of the article, Mihaela Olita, Andreea Tanase, Corina David, Simona Dima was omitted among the coauthors owing to an oversight from the corresponding author. Below is the updated list of authors and corresponding affiliations: Elena-Mihaela Vrabie(1,2), Mihai Adrian Eftimie (2,3), Ion Barbu (2), Iulian Mosteanu (2), Robert Ciortan (2), Alexandra Trotea(1,2), Bianca Badescu (2), Andreea Godja (2), Calina Aranghelovici (2), Cristina Abuzan-Constantin (2), Adriana Ion (2), Ovidiu Magdoiu (2), Irina Balescu (2,3), Gheorghe Potlog (1,2), Marian Tudoroiu (4), Elena Badea (4), Mihaela Olita (3,4), Andreea Tanase (4), Corina David (4), Ecaterina Scarlatescu (3,4), Mara Stefan (4), Alexandru Dinca (4), Raluca Istrate (4), Daniela Ungureanu (4), Daniela Dobre (4), Cristina Martac (4), Gabriela Droc (3,4), Simona Dima (2,3), Dana Tomescu (3,4), Nicolae Bacalbasa (1,2), Cezar Stroescu (2), Vladislav Brasoveanu (2,3) 1 Carol Davila University of Medicine and Pharmacy, Doctoral School, Bucharest, Romania 2 Department of General Surgery and Liver Transplant, Fundeni Clinical Institute, Bucharest, Romania 3 Carol Davila University of Medicine and Pharmacy, Bucharest, Romania 4 Department of Anesthesiology and Intensive Care, Fundeni Clinical Institute, Bucharest, Romania.</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":"121 ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147970853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Technical Approaches to Digestive Tract Reconstruction in Laparoscopic Pancreaticoduodenectomy - A Technical Note.","authors":"Călina Aranghelovici, Adrian Mihai Eftimie, Elena Mihaela Vrabie, Ion Barbu, Iulian Mosteanu, Alexandra Trotea, Gheorghe Potlog, Cezar Stroescu, Irina Balescu, Vladislav Brasoveanu, Nicolae Bacalbasa","doi":"10.21614/chirurgia.3282","DOIUrl":"10.21614/chirurgia.3282","url":null,"abstract":"<p><p>Pancreaticoduodenectomy is one of the most technically demanding procedures in digestive surgery. Historically, laparoscopy in pancreatic surgery was limited to staging and palliative interventions. Since the first laparoscopic pancreaticoduodenectomy was completed in 1994, significant advances have improved perioperative safety, operative time, and lowered postoperative morbidity. Nevertheless, the complexity of pancreatic surgery paired with the technical challenges of pancreatic minimally invasive approach have restricted laparoscopic pancreatoduodenectomy to high-volume centers until recent times. The aim of this technical note presentation is to describe novel laparoscopic techniques of performing the three anastomoses - pancreaticojejunostomy and pancreaticogastrectomy, hepaticojejunostomy, and gastrojejunostomy- in an intracorporeal fashion, highlighting methods of facilitating the reconstructive process. This technical note s purpose is to also present new training models for surgeons, meant to reduce post-operative complications, such as pancreatic fistula or biliary leakage, to shorten operating times, and, ultimately, to increase the availability of laparoscopic pancreaticoduodenectomy as a safe and efficient treatment option.</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":"121 2","pages":"219-227"},"PeriodicalIF":1.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Relevance of Biomarkers in Prostate Cancer: The Role of NKX3.1, AMACR, and Ki-67 in Risk Stratification - A Comprehensive Clinicopathological Analysis.","authors":"Mihai-Cătălin Roşu, Manuela Enciu, Mariana Aşchie, Cristina Anita Ionescu, Mihaela Pundiche, Nicolae Dobrin, Constanţa Ștefanov, Antonela-Anca Nicolau, Leopa Nicoleta, Bogdan Caraban, Sorin Deacu, Gabriela-Izabela Bălţătescu, Ionuţ Bulbuc, Ion Alexandru Popovici, Lucian Cristian Petcu","doi":"10.21614/chirurgia.3287","DOIUrl":"10.21614/chirurgia.3287","url":null,"abstract":"<p><p><b>Introduction:</b> Accurate risk stratification, essential for the therapeutic approach (especially surgical) of prostate cancer, is based on standard histopathological criteria. The biological heterogeneity of this neoplasm requires the identification of complementary markers that reflect the molecular mechanisms of tumor progression. The aim of this study was to evaluate the correlation between immunohistochemical markers of metabolism (AMACR, NKX3.1) and proliferation (Ki-67) and histopathological aggressiveness in ADK (prostate adenocarcinoma). <b>Methods:</b> This retrospective, single-center clinicopathological study included 385 patients with prostatic lesions from Sf. Apostol Andrei Emergency Clinical Hospital in Constanta (2023 2024). Of these, 198 cases of ADK were selected for the main immunohistochemical analysis. The cases were classified according to the Gleason system and Grade Groups. The expression of AMACR, NKX3.1 and Ki-67 markers was assessed by immunohistochemistry and correlated with Grade Groups, as well as with the presence of chronic inflammation and peritumoral glandular atrophy. <b>Results:</b> Increased AMACR expression (93.9% of cases) and increased Ki-67 index ( 20% in 29.3% cases) were significantly correlated with high Grade Groups (p 0.001). Loss of NKX3.1 expression increased from Grade Group 1 to Grade Group 4, followed by a lower frequency in Grade Group 5, indicating a non-linear association with histopathological grade (p for trend 0.001). The concomitant presence of chronic inflammation and glandular atrophy was associated with high Grade Groups and with a significantly higher Ki-67 index (p=0.001 and p 0.001). Triple staining (AMACR/p63/HMWCK) showed no discordant cases in distinguishing ADK from benign lesions that mimic prostate cancer. <b>Conclusions:</b> The extended immunohistochemical profile (AMACR, NKX3.1, Ki-67) provides valuable biological information correlated with tumor aggressiveness. Integrating these markers into the preoperative evaluation, along with standard histopathological evaluation and the peritumoral microenvironment, may contribute to a more accurate risk stratification. However, these findings are correlative, and their clinical applicability requires validation through further prospective studies.</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":"121 2","pages":"162-171"},"PeriodicalIF":1.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is the Dressing Optional? A Retrospective Comparison of Clinical Outcomes and Environmental Impact of Skin Glue Alone Versus Glue with Dressing After Open Inguinal Hernia Repair.","authors":"Nida Khan, Havil Stephen Alexander, Mukhil Rajendran, Dominika Krasicka, Premjithlal Bhaskaran, Rafique Umer Harvitkar, Christie Swaminathan, Victoria Pegna","doi":"10.21614/chirurgia.3290","DOIUrl":"10.21614/chirurgia.3290","url":null,"abstract":"<p><p><b>Introduction:</b> Open inguinal hernia repair is a frequently performed day-case operation. Cyanoacrylate skin adhesive provides a waterproof, occlusive seal and, in principle, does not require any additional postoperative dressing. Despite this, practice varies considerably, with many surgeons continuing to apply dressings out of habit rather than clinical necessity. As healthcare systems increasingly recognise the environmental impact of surgical consumables, understanding whether these dressings offer measurable benefits is essential. This study compared glue-only closure with glue plus dressing, evaluating clinical outcomes and the potential reduction in avoidable carbon emissions. Material and Method: A retrospective comparative analysis was undertaken of elective open inguinal hernia mesh repairs performed at our trust. Eighty patients were included: 40 managed with glue alone and 40 with glue plus dressing. Data collected included postoperative wound complications and dressing use. There was one wound infection in the glue plus dressing group and no wound infections in the glue only group. There was no statistically significant difference in infection rates between groups (1/40 vs 0/40; Fisher's exact test, p = 1.0). Overall wound complication rates were low in both groups. <b>Results:</b> Patients receiving dressings generated additional waste, with variable provision of take-home dressings resulting in an estimated 150 450 g CO2e per patient. Glue-only closure produced negligible dressing-related emissions. Additionally, patients in the glue-only group reported greater satisfaction with wound self care. Conclusion: The addition of postoperative dressings conferred no clinical advantage yet introduced avoidable environmental harm. Omitting routine dressings when glue is used is a safe, simple, and immediately adoptable measure to improve the sustainability of open inguinal hernia repair.</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":"121 Ahead of print","pages":"1-6"},"PeriodicalIF":1.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}