Chirurgia最新文献

{"title":"Evolution of Inguinal Hernia Management in a Romanian Emergency County Hospital: A Single-Centre Experience.","authors":"Vlad-Olimpiu Butiurca, Marian Botoncea, Catalin Dumitru Cosma, Ioulia Assmann, Calin Molnar","doi":"10.21614/chirurgia.3255","DOIUrl":"10.21614/chirurgia.3255","url":null,"abstract":"<p><p><b>Background:</b> Inguinal hernia repair is one of the most frequently performed procedures in general surgery. During the last decade, wider use of mesh-based open techniques and the introduction of laparoscopic TEP/TAPP have progressively changed practice, while the COVID-19 pandemic temporarily shifted case-mix toward emergencies. Material and Method: We conducted a retrospective, longitudinal, single-center study of 1,760 adult patients ( 18 years) admitted for inguinal hernia to Surgical Clinic No. I, Emergency County Hospital Targu Mures, between July 2013 and December 2021. Demographic data, admission type, incarceration, surgical approach, anesthesia and length of stay (LOS) were analyzed. Descriptive statistics and Welch t-tests were used for comparisons, and a multivariable logistic regression model was fitted to identify independent predictors of prolonged length of stay. <b>Results:</b> Male patients predominated (91.8%), with a median age of 61 years. Elective admissions accounted for 77.7% of cases, while 22.3% were emergencies. Laparoscopic repairs increased from 0.9% in 2013 to almost 30% in 2018-2019, then decreased to ~20% during the COVID-19 period. Open repair remained dominant (84.9%). Mean LOS was 3.31 days and was significantly longer in emergency versus elective cases (3.98 vs 3.12 days), open versus laparoscopic repairs (3.52 vs 2.19 days) and incarcerated versus non-incarcerated hernias (4.13 vs 3.22 days) (all p 0.001). <b>Conclusions:</b> Our clinic followed the international trend from non-mesh open to mesh and laparoscopic techniques. Emergency presentation, incarceration and open surgery were each associated with prolonged hospitalization, while the COVID-19 pandemic temporarily reduced elective and laparoscopic repairs.</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":"121 1","pages":"70-76"},"PeriodicalIF":1.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147364146","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":"Resection of the Uncinate Process of the Pancreas - An Exceptional Alternative to Pancreaticoduodenectomy for Non-Enucleable Benign and Low-Grade MalignantTumors of the Uncinate Process. Surgical Technique, Case Report and Literature Review.","authors":"Traian Dumitraşcu","doi":"10.21614/chirurgia.3268","DOIUrl":"10.21614/chirurgia.3268","url":null,"abstract":"<p><p>Tumors located in the uncinate process of the pancreas are traditionally resected by pancreaticoduodenectomy (PD), a surgical procedure that carries high morbidity and non-negligible mortality rates. Thus, for selected cases of benign and low-grade malignant tumors, more conservative pancreatic resections were proposed. Hereby, we describe the technique of resection of the uncinate process of the pancreas (RUP) in a 64-year-old female patient diagnosed with a well-differentiated neuroendocrine tumor, with an uneventful early postoperative outcome. Furthermore, a comprehensive literature search across databases was conducted to identify papers on the indications and outcomes of RUP. In conclusion, RUP is an exceptional yet feasible and safe alternative to PD for carefully selected patients with non-enucleable benign or low-grade malignant tumors of the uncinate process, eliminating the burden of postoperative mortality and long-term endocrine and exocrine insufficiency associated with PD. However, RUP is a complex surgical procedure that requires precise knowledge of the pancreas anatomy. Considering the limited number of patients reported with RUP, further studies are needed to confirm the real benefits of this challenging technique.</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":"121 1","pages":"94-103"},"PeriodicalIF":1.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147364336","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":"PeTEP Technique in Primary Ventral Hernia Repair Associated with Diastasis Recti (with video).","authors":"Diana Teodora Suhaciu, Victor Gheorghe Radu, Traian Patrascu","doi":"10.21614/chirurgia.3070","DOIUrl":"10.21614/chirurgia.3070","url":null,"abstract":"<p><p>video width=\"640\" height=\"480\" controls controlsList=\"nodownload\" poster=\"https://www.revistachirurgia.ro/pdfs/video/Diana_Teodora_Suhaciu-Diastasis_Recti_Umbilical_hernia_repair_PeTEP.jpg\" style=\"margin-top: -20px;\" source src=\"https://www.revistachirurgia.ro/pdfs/video/Diana_Teodora_Suhaciu-Diastasis_Recti_Umbilical_hernia_repair_PeTEP.mp4\" type=\"video/mp4\" Your browser does not support the video tag. /video We present a new approach in the repair of primary ventral hernia associated with diastasis recti. This involves the totally extraperitoneal robotic approach, recently published by Dr. Hector Valenzuela, performing a laparoscopic surgery. The advantages of robot-assisted surgery include the precision of dissection and preservation of the peritoneum's integrity, even under conditions of high fragility, enhanced intraoperative comfort, and as a result, increased reproducibility. We believe that restoring the linea alba and placing the parietal prosthesis outside the peritoneal cavity, in addition to eTEP, without cutting any fascial structures, represents a step forward in the evolution of minimally invasive surgery for ventral hernias.</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":"121 1","pages":"110-112"},"PeriodicalIF":1.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147364313","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":"Advances and Ongoing Challenges in Colorectal Cancer.","authors":"Silviu Stefan Marginean, Petru Adrian Radu, Mihai Zurzu, Dragos Garofil, Vlad Paic, Anca Tigora, Mircea Bratucu, Florian Popa And","doi":"10.21614/chirurgia.3262","DOIUrl":"10.21614/chirurgia.3262","url":null,"abstract":"<p><p>Colorectal cancer (CRC) remains a major global health concern, with a rising incidence among younger adults and persistently high mortality in advanced stages, despite significant scientific and technological progress. Its etiology is multifactorial, involving lifestyle factors, genetic susceptibility, chronic inflammation, and gut microbiome dysbiosis. Recent advances in screening, molecular profiling, surgery, and systemic therapies have substantially reshaped CRC management. This narrative review was conducted through a comprehensive literature search of PubMed/MEDLINE, Scopus, and Web of Science databases, covering publications from January 2015 to June 2025. Peer-reviewed articles addressing CRC epidemiology, molecular pathways, screening and diagnostic strategies, surgical management, systemic therapies, and emerging treatment modalities were selected. Evidence was qualitatively synthesized and organized into clinically relevant thematic domains. Recent progress in CRC screening, including advanced endoscopic imaging, fecal DNA testing, and blood-based biomarkers, has improved early detection, although implementation remains uneven. Molecular characterization such as MSI-H/dMMR status, RAS/RAF mutations, HER2 amplification, and consensus molecular subtypes â?\" guides prognostic assessment and personalized therapy. Surgical resection remains the cornerstone of curative-intent treatment, with minimally invasive and robotic approaches reducing morbidity while maintaining oncologic safety. Techniques such as complete mesocolic excision and total mesorectal excision, along with multimodal strategies for advanced disease, have expanded therapeutic options. Despite these advances, challenges persist, including therapeutic resistance, tumor heterogeneity, limited immunotherapy efficacy in microsatellite-stable disease, and rising early-onset CRC. Future progress relies on precision medicine, ctDNA-guided monitoring, microbiome-targeted strategies, and optimized surgical selection.</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":"121 1","pages":"27-42"},"PeriodicalIF":1.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147364115","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":"Transdiaphragmatic Intercostal Hernia Following Blunt Trauma and Coughing: A Case Report and Literature Review.","authors":"Mihnea Bogdan Borz, Patrik Buzgau, Paul Cristian Borz, Oliviu Cristian Borz, Bogdan Andrei Suciu","doi":"10.21614/chirurgia.3233","DOIUrl":"10.21614/chirurgia.3233","url":null,"abstract":"<p><p><b>Background:</b> Transdiaphragmatic intercostal hernias (TDIHs) are rare, frequently underdiagnosed conditions characterized by herniation of abdominal contents through concurrent defects in the diaphragm and intercostal musculature. They usually result from blunt or penetrating trauma but may also occur spontaneously following episodes of markedly increased intra-abdominal pressure, such as forceful coughing. Case presentation: We present the case of a 68-year-old male with a large TDIH manifesting as a progressively enlarging left thoracoabdominal mass after blunt trauma and a severe coughing episode. The initial diagnosis was of a large hernia of the lateral abdominal wall. Diagnostic imaging revealed a significant diaphragmatic defect with herniation of the omentum and splenic flexure through the thoracic wall. Surgical repair was performed by a multidisciplinary team via a posterolateral thoracotomy with primary diaphragmatic closure and thoracic wall reconstruction. The postoperative course was uneventful, with no recurrence at six months. Conclusion: This case highlights the importance of high clinical suspicion, advanced imaging, and collaborative surgical management in treating this rare entity. Also, a literature review is presented.</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":"121 1","pages":"104-109"},"PeriodicalIF":1.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147364301","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":"Predictive Factors for the Occurrence of Low Anterior Resection Syndrome after Surgical Intervention.","authors":"Roxana-Elena Ștefan, Adrian Constantin, Daniela Dinu, Florin Achim, Alexandru Rotariu, Florin Grama, Horia Lişcu, Mircea Gheorghe, Anthony Răsuceanu, Silviu Constantinoiu, Dragoş Predescu","doi":"10.21614/chirurgia.3253","DOIUrl":"10.21614/chirurgia.3253","url":null,"abstract":"<p><p><b>Introduction:</b> Surgical procedures for rectal cancer frequently result in intestinal dysfunction, leading to a wide range of digestive symptoms with variable intensity and duration. Thus, patients undergoing low anterior resection with anal sphincter preservation often report fecal incontinence, fecal urgency, incomplete or difficult evacuation, and obstruction. All these symptoms are known as low anterior resection syndrome (LARS). This study analyzes the factors leading to the occurrence of LARS in patients who underwent low anterior resection with colorectal anastomosis or ultralow anterior resection with coloanal anastomosis. <b>Materials and Methods:</b> This study is based on a retrospective analysis of patients with rectal cancer, hospitalized and treated in two surgical centers experienced in colorectal surgery, between January 2018 and December 2023. <b>Results:</b> Out of a total of 86 patients (55 men, 31 women) with a mean age 64 years, who underwent low anterior resection with colorectal anastomosis or ultralow anterior resection with coloanal anastomosis (immediate or delayed), 40 patients (27 men, 13 women) developed postoperative LARS (mean age 65 years). The most frequent cases of LARS were recorded after ultralow anterior resection with delayed coloanal anastomosis (18/40), followed by low anterior resection (12/40), and ultralow anterior resection with immediate coloanal anastomosis (10/40). <b>Conclusions:</b> Low anterior resection syndrome is influenced by multiple factors, including the type of surgical intervention, anastomosis technique, tumor distance from the anal verge, and advanced local tumor stages.</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":"121 1","pages":"43-54"},"PeriodicalIF":1.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147364383","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 and Functional Implications of Lenke Type 3 Idiopathic Scoliosis in Children and Adolescents: A Comparative Study.","authors":"Nicoleta Leopa, Iulian Manac, Răzvan Cătălin Popescu, Daniel Ovidiu Costea, Mihaela Pundiche, Sanda Jurja, Florina Anca Manac, Traian Virgiliu Surdu, Monica Surdu, Ioana Georgia Oglindă, Alexandru Vicenţiu Vâlcu, Stere Popescu, Florin Daniel Enache","doi":"10.21614/chirurgia.3236","DOIUrl":"10.21614/chirurgia.3236","url":null,"abstract":"<p><p><b>Background:</b> Lenke type 3 double major curves represent a complex deformity that may progress rapidly during pediatric development and often raise early surgical considerations. This study aimed to compare clinical, radiographic, and quality-of-life (QoL) characteristics between children and adolescents with Lenke type 3 scoliosis and to explore age-related factors that may influence future surgical decision-making. <b>Methods:</b> A cross-sectional analysis was conducted on pediatric patients diagnosed with Lenke type 3 double major curves, divided into two groups: children ( 12 years) and adolescents (12-16 years). Demographic, clinical, and radiographic parameters were recorded, including thoracic and lumbar major coronal curves, axial rotation, and inflection points. QoL was assessed using the SRS-22r questionnaire. <b>Results:</b> Adolescents presented with significantly greater thoracic major coronal curve (p 0.01) and reported lower quality of life scores, particularly in the Pain (p=0.008) and Appearance (p=0.001) domains of the SRS-22r questionnaire. A moderate inverse correlation was observed between thoracic major coronal curve and both Function (r=â?\"0.45, p=0.011) and Appearance (r=\"0.52, p=0.004) scores. Lumbar major coronal curve did not show significant associations with quality of life domains. Children reported overall higher quality of life scores across all domains, although Mental Health differences were not statistically significant between groups. <b>Conclusions:</b> Adolescents with Lenke type 3 scoliosis demonstrate more advanced deformity and greater QoL impairment than younger children, even before reaching classical surgical thresholds. Age-related psychosocial decline and thoracic curve progression may represent early indicators relevant for surgical planning and timing of intervention.</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":"121 1","pages":"85-93"},"PeriodicalIF":1.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147364328","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":"Optimizing RIRS in Complex Renal Anatomy: A Comparative study of Tip-Flexible Suction versus Conventional Ureteral Access Sheath.","authors":"Ovidiu-Cătălin Nechita, Daniel Liviu Bădescu, Cosmin-George Radu, Cristian-Valentin Toma, Cristian-Sorin Sima, Ionuţ Diţescu, George Sabin Popescu, Justin Aurelian, George Daniel Rădăvoi, Bogdan Geavlete, Viorel Jinga","doi":"10.21614/chirurgia.3190","DOIUrl":"10.21614/chirurgia.3190","url":null,"abstract":"<p><strong>Background/objectives: </strong>Managing kidney stones in patients with congenital renal anomalies - such as horseshoe kidney or ectopic kidney - presents unique challenges for endourologists. In these anatomically complex cases, standard ureteral access can be difficult, and pressure management becomes critical. Suction-assisted ureteral access sheaths have emerged as a promising solution, but clinical data in this population remain limited. This study evaluates whether using a tip-flexible suction UAS improves outcomes in retrograde intrarenal surgery compared to conventional access. <b>Methods:</b> We retrospectively reviewed 67 patients with confirmed renal anomalies and stones sized 2-4 cm who underwent RIRS at two academic centers between October 2022 and December 2024. Patients were grouped based on the type of UAS used: suction-assisted (TFS-UAS) or conventional (T-UAS). Surgical and postoperative outcomes, including stone-free rate (SFR), complication profile, operative time, and hospital stay, were compared. <b>Results:</b> The TFS-UAS group showed a higher 30-day SFR (94.3%) compared to the conventional group (81.3%), although the difference was not statistically significant. Operative time was longer with TFS-UAS (p 0.001), but this was offset by a shorter hospital stay (p = 0.003). No major differences were seen in complication rates. <b>Conclusions:</b> Using a suction-assisted UAS during RIRS in patients with congenital renal anomalies offers notable clinical benefits. Primarily, it increases the chance of removing all stone fragments and often results in a shorter, easier recovery. While this technique may increase procedural time, the overall advantages, such as improved success rates and easier recovery, typically justify the additional time.</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":"121 1","pages":"77-84"},"PeriodicalIF":1.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147364288","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":"Increased Rate of Minimally Invasive Surgery and Improved Outcomes in Colorectal Surgery Following Implementation of LAPCO-Ro.","authors":"Victor Tomulescu, Draga-Maria Mandi, Cătălin Copaescu","doi":"10.21614/chirurgia.3260","DOIUrl":"10.21614/chirurgia.3260","url":null,"abstract":"<p><p><b>Background:</b> Despite the recognised benefits of laparoscopic colorectal surgery (LCS), its uptake in Romania has remained low, with less than 4% of cases performed using laparoscopy in 2018. To address this gap, LAPCO Romania (LAPCO-Ro), modelled on the UK National Training Programme, was established as a structured network for mentorship, competency-based evaluation and faculty development. The objective of this study is to evaluate the impact of this programme on the use of minimally invasive surgery in colorectal pathology and on complication rates. <b>Methods:</b> We describe the structure and early experience of LAPCO-Ro and evaluate its effect on nationwide LCS implementation, focusing on changes in adoption rates, comparison of complication rates between procedures supervised by LAPCO-Ro and those that were not, and projections of national outcomes in the absence of the programme. <b>Results:</b> From 2017 to 2024, the proportion of laparoscopic colorectal resections in Romania increased from 3.2% to 11.6%. Complication rates for laparoscopic cases remained consistently lower than open surgery (mean 2.8% vs 4.8%), with relative risk ranging from 0.31 to 0.87, indicating a 13 69% reduction in morbidity compared to open procedures. Excluding LAPCO-Ro trainee-related cases, the national trend in Romania would have followed its earlier linear trajectory (+177 cases/year), reaching only about 10% laparoscopic adoption by 2024 instead of the actual 13%. LAPCO-Ro thus accelerated national diffusion by 30 35%, resulting in approximately 500 additional minimally invasive colectomies in 2024 and over 1,000 since the start of the programme. Within LAPCO-Ro, mentored laparoscopic colorectal cases were associated with low postoperative morbidity (2.46%). <b>Conclusions:</b> The LAPCO-Ro experience demonstrates that a structured, competency-based national training network can accelerate the dissemination of minimally invasive colorectal surgery in a late-adopter health system.</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":"121 1","pages":"55-61"},"PeriodicalIF":1.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147364357","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":"Robotic versus Laparoscopic Surgery in Upper Gastrointestinal Procedures: A Narrative Review of Recent Literature.","authors":"Serena Guarriello, Jacopo Andreuccetti, Giusto Pignata","doi":"10.21614/chirurgia.3227","DOIUrl":"10.21614/chirurgia.3227","url":null,"abstract":"<p><p><b>Introduction:</b> Robotic-assisted surgery overs theoretical advantages over laparoscopy for upper gastrointestinal (UGI) procedures including three-dimensional visualization, enhanced dexterity, and improved ergonomics. However, its clinical impact remains debated given longer operative times and higher costs. <b>Methods:</b> We conducted a narrative review searching PubMed/MEDLINE, Embase, Cochrane Library, and Web of Science for studies published between January 2020 and August 2025 comparing robotic versus laparoscopic or open surgery for gastroesophageal pathologies. Studies were included if they reported perioperative, oncological, or long-term outcomes in patients with gastric cancer, esophageal cancer, gastroesophageal reflux disease, or hiatal hernia. Sixteen studies were included comprising 3 randomized controlled trials, 6 meta-analyses, and 7 observational studies. <b>Results:</b> For gastric cancer, robotic gastrectomy demonstrated reduced blood loss, lower conversion rates, enhanced lymph node retrieval, and decreased complications across meta-analyses of 68,755+ patients, with comparable oncological outcomes. Three-dimensional laparoscopy achieved similar results in several domains. For esophagectomy, robotic approaches showed substantial reductions in pulmonary complications, overall morbidity, and improved quality of life versus conventional minimally invasive and open surgery, with higher R0 resection rates. For functional foregut surgery, robotic Heller myotomy demonstrated fewer perforations and reinterventions, while fundoplication and hiatal hernia repair showed equivalent outcomes. All robotic procedures had longer operative times. <b>Conclusions:</b> Robotic surgery offers measurable perioperative benefits in UGI procedures, strongest for esophagectomy. For gastric cancer, advantages support selective use though three-dimensional laparoscopy narrows the gap. Benefits in foregut surgery are procedure-specific. Laparoscopy remains standard due to efficacy, accessibility, and cost. Further randomized trials with long-term follow-up and cost-effectiveness analyses are needed.</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":"121 1","pages":"5-12"},"PeriodicalIF":1.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147364310","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}