Chirurgia最新文献

{"title":"Sentinel Lymph Node Mapping in Endometrial Cancer: Our Initial Experience in a Resource Limited Setting.","authors":"Szilárd Leó Kiss, Mihai Stanca, Dan Mihai Căpîlnă, Tudor Emil Căpîlnă, Maria Pop-Suciu, Botond Istvan Kiss, Szilárd Leó Kiss, Mihai Emil Căpîlnă","doi":"10.21614/chirurgia.3155","DOIUrl":"10.21614/chirurgia.3155","url":null,"abstract":"<p><p><b>Background:</b> Nodal status is one of the most important prognostic factors in endometrial cancer (EC), but systematic lymphadenectomy is associated with significant morbidity. Sentinel lymph node (SLN) mapping offers a less invasive alternative. However, data are limited where indocyanine green is unavailable. \u0000<b>Methods:</b> Between November 2019 and March 2025, 29 women with FIGO stage Iâ?\"III EC were prospectively enrolled in this study. Cervical injection of methylene blue, with or without technetium-99m, was used for SLN mapping. Ultrastaging was performed routinely. In patients with high-risk disease, full pelvic and para-aortic lymphadenectomy was also performed. Detection rates, sensitivity, and negative predictive value (NPV) were calculated. \u0000<b>Results:</b> Overall and bilateral detection rates were 75% and 48%, respectively (methylene blue: 72% / 44%; dual tracer: 100% / 75%). Nodal metastases were identified in 9 of 29 patients (31%). Patient-level sensitivity was 71%, with an NPV of 88%. Application of the side-specific completion algorithm increased sensitivity to 86%. Side-specific sensitivity and NPV reached 100%. Lymphovascular space invasion and 50% myometrial invasion were significantly associated with nodal metastasis (p 0.05). No mapping-related complications were observed. \u0000<b>Conclusions:</b> SLN mapping with methylene blue, with or without technetium, combined with a side-specific completion algorithm, enables reliable nodal staging even without fluorescence imaging.</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":"120 5","pages":"529-537"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145451107","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":"Comparative Analysis of Nutritional and Immune Status using the Conut Score in Patients Undergoing Billroth I and Billroth II / Roux-en-Y Reconstruction.","authors":"Cătălin Cosma, Vlad Olimpiu Butiurca, Cosmin Nicolescu, Paul Cristian Russu, Marian Botoncea, Călin Molnar","doi":"10.21614/chirurgia.3218","DOIUrl":"10.21614/chirurgia.3218","url":null,"abstract":"<p><p><b>Background:</b> Gastric cancer surgery requires not only oncological radicality but also functional reconstruction. Billroth I remains the most physiological method of restoring continuity, whereas Billroth II and Roux-en-Y are most frequently adopted in the oncological treatment. Nutritional and immune competence strongly influence postoperative outcomes, and the Controlling Nutritional Status (CONUT) score has emerged as a validated biomarker integrating albumin, lymphocyte count, and cholesterol in predicting complications in surgically treated patients. \u0000<b>Methods:</b> We conducted a prospective observational single-center study including 150 patients undergoing curative distal gastrectomy between October 2021 and December 2024. Reconstruction was performed using Billroth I (n=72) or Billroth II/Roux-en-Y (n=78). The CONUT score was assessed preoperatively (T0), early postoperatively (T1), and at three months (T2). Outcomes included CONUT evolution, postoperative complications (Clavien Dindo), length of stay, readmission, and mortality. \u0000<b>Results:</b> Both reconstruction groups demonstrated a significant postoperative increase in CONUT score (median 2 [1-3] at T0 to 3 [2-4] at T1, p 0.001), followed by partial recovery at three months. No differences were observed between Billroth I and Billroth II/Roux-en-Y at any timepoint. Higher CONUT values at T0, T1, and T2 independently predicted overall and major complications (OR range 1.15 1.25, p 0.05). Postoperative morbidity, mortality (3.3%), and hospital stay were similar across groups. \u0000<b>Conclusions:</b> The CONUT score is an independent predictor of perioperative morbidity in gastric cancer, while the choice of reconstruction method does not significantly alter immunonutritional trajectories. Serial CONUT monitoring may enhance perioperative risk stratification.</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":"120 5","pages":"566-574"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145450831","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":"Histopathological Profile of Prostatic Lesions and the Role of Gleason Score in Surgical Treatment Decision-Making.","authors":"Mihai-Cătălin Roşu, Cristina Anita Ionescu, Manuela Enciu, Bogdan Cã Mpineanu, Mihaela Pundiche, Nicolae Dobrin, Ionuà Iorga, Mariana Deacu, Oana Cojocaru, Ionuţ Burlacu, Miruna-Gabriela Vizireanu, Anca Chisoi, Ionuţ Poinareanu, Lucian Cristian Petcu","doi":"10.21614/chirurgia.3212","DOIUrl":"10.21614/chirurgia.3212","url":null,"abstract":"<p><p><b>Introduction:</b> The Gleason score plays a key role in risk stratification and surgical treatment selection for prostate cancer. This study evaluates the correlation between Gleason score, patient age, and tumor aggressiveness, with implications for medical practice. \u0000<b>Methods:</b> This retrospective study included 215 patients from Sf. Apostol Andrei Clinical Emergency Hospital of Constanta County (2023-2024) with histopathologically confirmed prostate lesions. Demographic variables (age), Gleason score (classified according to ISUP 2019), and histological grade were analyzed. Data were statistically analyzed using t tests, ANOVA, and logistic regression. While international guidelines provide a standardized framework for management, local and regional variations in healthcare access, diagnostic pathways, and patient preferences significantly influence real-world clinical practice. This study aims to describe the histopathological spectrum of prostatic lesions and evaluate the prognostic relevance of the Gleason score in surgical decision-making within the specific context of a Romanian tertiary care center. By highlighting regional particularities, such as the high burden of aggressive disease and the challenges in implementing active surveillance, our findings contribute to a more nuanced understanding of global prostate cancer care. \u0000<b>Results:</b> Benign prostatic hyperplasia (BPH) accounted for 42.8% of cases, PCa for 44.7%, and urothelial carcinoma for 8.4%. Among prostate cancers, 87.5% had clinically significant disease (Gleason >=7), with 29.2% high-risk (Gleason 8-10). Gleason 7 was most frequent (58.3%), predominantly 3+4. A significant correlation was observed between advanced age ( >70 years) and tumor aggressiveness (OR = 2.3; 95% CI: 1.4-3.8). Radical prostatectomy was primarily chosen for Gleason scores >=7, with higher complication rates in older patients. \u0000<b>Conclusions:</b> Advanced age and a high Gleason score are independent factors of tumor aggressiveness. Early surgical intervention in patients with Gleason >=7 improves oncological outcomes. Integrating histopathology with multiparametric MRI and molecular biomarkers could optimize management of these patients.</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":"120 5","pages":"593-602"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145451015","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 Features and Outcomes of Patients with Acute Mesenteric Ischaemia in a Retrospective Study.","authors":"Giuseppe Evola, Marco Vacante, Francesco Roberto Evola, Martina Barchitta, Grazia Maugeri, Giuseppe Musumeci, Velia D'Agata, Guido Basile","doi":"10.21614/chirurgia.3127","DOIUrl":"10.21614/chirurgia.3127","url":null,"abstract":"<p><p><b>Background:</b> Intestinal ischaemia is an abdominal emergency characterized by a drastic reduction in blood flow in the mesenteric vessels with the possible onset of necrosis of the small intestine and/or colon. Its incidence is rather rare and the diagnosis is very difficult as the clinical presentation is not specific and there are no pathognomonic laboratory tests. \u0000<b>Methods:</b> A retrospective study was carried out on 28 patients with intestinal infarction, including analysis of the risk factors, comorbidities, symptoms, laboratory tests and instrumental investigations, to determine the presence of eventual signs of mesenteric ischaemia secondary to vascular insufficiency. \u0000<b>Results:</b> Twenty-four patients (85%) underwent surgery and intestinal necrosis was found in all. Among these, a quite high mortality rate (64%) was observed. \u0000<b>Conclusion:</b> The retrospective study confirmed the low frequency, high mortality and diagnostic difficulty of mesenteric ischaemia in its various clinical forms. Currently, there are neither laboratory tests nor instrumental techniques that can give a certain diagnosis of acute mesenteric ischaemia in an early phase. However, strong clinical suspicion, a rapid diagnosis and an aggressive therapeutic approach could improve the clinical results and reduce its high mortality.</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":"120 Ahead of print","pages":"1-10"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145376652","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":"Predicting Outcomes in Hepatocellular Carcinoma Surgery: ALBI is the Better Tool. An Observational Cohort Study.","authors":"Raluca Zaharia, Stefan Morarasu, Andreea Antonina Ivanov, Gabriel Mihail Dimofte, Sorinel Lunca","doi":"10.21614/chirurgia.3146","DOIUrl":"10.21614/chirurgia.3146","url":null,"abstract":"<p><p><b>Background:</b> Hepatic resection is a key curative option for hepatocellular carcinoma (HCC), but postoperative morbidity and early mortality remain significant concerns, especially in patients with impaired liver function. Accurate preoperative risk stratification is essential to improve outcomes. This study compares the predictive value of three liver function scores - MELD, ALBI, and Child-Pugh - for postoperative morbidity and 30-day mortality. \u0000<b>Methods:</b> A retrospective study was conducted on 55 patients who underwent hepatic resection for HCC between 2013 and 2024 at a single tertiary center. Preoperative MELD, ALBI, and Child-Pugh scores were calculated and analyzed in relation to postoperative complications and mortality. Diagnostic performance was assessed using sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and ROC curves. \u0000<b>Results:</b> Postoperative morbidity occurred in 23.6% of patients, with a 30-day mortality rate of 9.1%. The ALBI score showed the highest specificity (73.8%) and NPV (81.6%) for morbidity prediction. It also demonstrated perfect sensitivity (100%) and NPV (100%) for post-hepatectomy liver failure (PHLF), with an AUC of 0.85. Patients with ALBI Grade 1 had fewer complications and shorter hospital stays. MELD showed moderate predictive value, particularly in ruling out mortality. The Child-Pugh score had the weakest performance, primarily due to low sensitivity. \u0000<b>Conclusion:</b> ALBI is the most accurate and objective score for identifying high-risk patients undergoing liver resection for HCC. MELD provides additional value in mortality exclusion. The limited sensitivity of Child-Pugh suggests it should be used with caution. Incorporating ALBI into preoperative assessment may enhance surgical decision-making and risk stratification.</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":"120 5","pages":"555-565"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145451123","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":"Augmented Reality Integration for Surgical Enhancement in Hepatic Surgery - Review of the Current Literature.","authors":"David Andraş, Radu Alexandru Ilieş, Alexandru Ilie-Ene, Victor Eşanu, Vasile Binţinţan, George Dindelegan","doi":"10.21614/chirurgia.3115","DOIUrl":"10.21614/chirurgia.3115","url":null,"abstract":"<p><strong>Background: </strong>Intrahepatic anatomy remains a challenge in mini-invasive liver surgery. Augmented Reality (AR), which integrates digital information with the user's environment, can benefit liver surgery by improving tumor and vessel positioning, resection planning, and surgical training. This review highlights AR's applications in liver surgery.</p><p><strong>Methods: </strong>Articles published from 2010-2024 on PubMed using keywords (\"Augmented Reality\" AND \"Liver Surgery\") OR (\"Navigation\" AND \"Liver Surgery\") were analyzed. 32 articles assessing AR's accuracy, safety, operative time, and training impact were included.</p><p><strong>Results: </strong>AR in Image-Guided Surgery (IGS) combines 3D reconstructions (e.g., CT scans) with laparoscopic images, enhancing the understanding of the surgical site. AR aids in margin planning, lesion boundary setting, and accurate hemostasis. It improves oncological outcomes, reduces errors, increases accuracy, and sometimes shortens surgery time. AR also enhances surgical training by accelerating skill acquisition and reducing the learning curve. However, more data is needed to standardize AR techniques.</p><p><strong>Conclusion: </strong>AR can significantly enhance mini-invasive liver surgery by improving precision, safety, efficiency, and training. While further research is necessary to standardize techniques, AR holds great potential for improving surgical outcomes and training quality.</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":"120 5","pages":"491-501"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145450528","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":"Comparative Evaluation of Ultrasound and Mammography for Assessing Resection Margins in Breast-Conserving Therapy for Breast Cancer.","authors":"Rares Georgescu, Orsolya Bauer, Sabin Turdean, Flavian Tutuianu, Eugeniu Darii, Paula Moraru, Anca Toganel, Cristina Tutuianu Radoi","doi":"10.21614/chirurgia.3099","DOIUrl":"10.21614/chirurgia.3099","url":null,"abstract":"<p><p><b>Introduction:</b> Various techniques for intraoperative measurement of resection margins have been explored to prevent positive margins in breast-conserving surgery. Although multiple methods exist, none is perfect, and most are costly and not easily accessible. \u0000<b>Material and Methods:</b> This prospective study was conducted at the Surgical Clinic of Mures County Clinical Hospital, utilizing data from breast cancer patients who underwent conservative treatment between 2014 and 2019. Resection margins were measured using ultrasound and mammography, and these values were compared with histopathological reports. \u0000<b>Results:</b> A total of 166 patients were enrolled, with 10 patients (6.02%) having positive resection margins. For ultrasound, at a 2 mm cut-off, sensitivity was 63.86% and specificity was 93.98%; at a 5 mm cut-off, sensitivity increased to 95.78% with the same specificity of 93.98%. For mammography, at a 2 mm cut-off, sensitivity was 6.627% and specificity was 93.98%; at a 5 mm cut-off, sensitivity was 37.35% with the specificity remaining at 93.98%. \u0000<b>Conclusions:</b> Ultrasound at a 5 mm cut-off showed higher sensitivity compared to a 2 mm cut-off, while mammography showed low sensitivity at both cut-offs. These results indicate that, while both methods have high specificity, their accuracy and sensitivity vary, necessitating cautious interpretation for clinical use.</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":"120 5","pages":"546-554"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145450860","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":"Perioperative Risk in Colon Cancer: The Dual Burden of Tumor-Related Anemia and Cardiac Comorbidity.","authors":"Nicoleta Leopa, Andreea Badea, Mihaela Pundiche, Mihaela Botnarciuc, Viorel Ispas, Stefan Paitici, Irinel Raluca Parepa, Cristina Tocia, Andrei Dumitru, Ioana Popescu, Sorina Ispas, Dimitrie Buşu, Rã Zvan Cătălin Popescu","doi":"10.21614/chirurgia.3211","DOIUrl":"10.21614/chirurgia.3211","url":null,"abstract":"<p><p><b>Background:</b> Colon cancer is a common malignancy with significant complications, particularly gastrointestinal bleeding and anemia, requiring emergent transfusions. The aim of the study is to explore the complex relationship between emergent transfusions in colon cancer patients and their concurrent cardiac pathology. \u0000<b>Methods:</b> A retrospective case-control study conducted between January 2020 - February 2024 in South-Eastern Romania focused on adult patients with colon cancer and moderate/severe anemia. The study included patients with advanced-stage colon adenocarcinoma, complicated tumors requiring blood transfusions, and excluded those with mild anemia, cancer history, or previously transfusions for the same condition. Patients were analyzed based on their anemia severity, demographic and clinical characteristics, and perioperative outcomes, with a specific focus on the impact of concurrent cardiac pathology. \u0000<b>Results:</b> The study included 153 patients, divided into two groups based on anemia severity: moderate anemia (MA, n=124) and severe anemia (SA, n=29). No significant differences were found in tumor histopathology or stage between the two groups, though significant differences were observed in blood loss, invasions, and transfusion needs. Postoperative outcomes showed a higher rate of complications, longer hospital stays, and increased mortality in the SA group compared to the MA group. Additionally, cardiac comorbidities were associated with more severe anemia, increased intraoperative blood loss, longer surgery duration, and a higher need for transfusions, as well as more frequent postoperative complications. \u0000<b>Conclusions:</b> Severe anemia and pre-existing cardiac conditions are linked to poorer surgical outcomes, greater transfusion requirements, and higher complication rates.</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":"120 5","pages":"575-582"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145451119","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 Features and Outcomes of Patients with Acute Mesenteric Ischaemia in a Retrospective Study.","authors":"Giuseppe Evola, Marco Vacante, Francesco Roberto Evola, Martina Barchitta, Grazia Maugeri, Giuseppe Musumeci, Velia D'Agata, Guido Basile","doi":"10.21614/chirurgia.3127","DOIUrl":"10.21614/chirurgia.3127","url":null,"abstract":"<p><p><b>Background:</b> Intestinal ischaemia is an abdominal emergency characterized by a drastic reduction in blood flow in the mesenteric vessels with the possible onset of necrosis of the small intestine and/or colon. Its incidence is rather rare and the diagnosis is very difficult as the clinical presentation is not specific and there are no pathognomonic laboratory tests. \u0000<b>Methods:</b> A retrospective study was carried out on 28 patients with intestinal infarction, including analysis of the risk factors, comorbidities, symptoms, laboratory tests and instrumental investigations, to determine the presence of eventual signs of mesenteric ischaemia secondary to vascular insufficiency. \u0000<b>Results:</b> Twenty-four patients (85%) underwent surgery and intestinal necrosis was found in all. Among these, a quite high mortality rate (64%) was observed. \u0000<b>Conclusion:</b> The retrospective study confirmed the low frequency, high mortality and diagnostic difficulty of mesenteric ischaemia in its various clinical forms. Currently, there are neither laboratory tests nor instrumental techniques that can give a certain diagnosis of acute mesenteric ischaemia in an early phase. However, strong clinical suspicion, a rapid diagnosis and an aggressive therapeutic approach could improve the clinical results and reduce its high mortality.</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":"120 5","pages":"583-592"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145450773","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":"Case Report of Rhino-Orbital Mucormycosis Associated with COVID-19.","authors":"Ana-Maria Stoica, Elena Mocanu, Sanda Jurja","doi":"10.21614/chirurgia.3205","DOIUrl":"https://doi.org/10.21614/chirurgia.3205","url":null,"abstract":"<p><p>Rhino-orbital mucormycosis is an uncommon invasive fungal infection caused by a fungus belonging to the order Mucorales. It is a lifethreatening, fulminant disease with high rates of morbidity and mortality despite treatment. Immunocompromised patients are primarily affected, and it almost always occurs in patients with uncontrolled diabetes mellitus, especially those in diabetic ketoacidosis. The second wave of the COVID-19 pandemic emerged with increased reports of rhino-orbital mucormycosis, especially in India. It has been widely suggested that prolonged steroid therapy coupled with dysglycemia resulting from diabetes provides an excellent opportunity for fungal invasion. We report the case of a 64-year-old male admitted to our clinic in September 2024 with the presumptive diagnosis of right orbital cellulitis. The patient's history revealed recent COVID-19-related pneumonia, hospitalized in a different hospital, and type 2 diabetes mellitus with insulin treatment. After extensive paraclinical investigations, and given the rapid evolution of the clinical signs, despite intensive and complex therapy, we concluded the diagnosis of Rhino-orbital mucormycosis. Our case supports the hypothesis that the ominous triad of diabetes, corticosteroid use, and the background of COVID-19 determines the increased risk of mucormycosis, and that extensive research must be conducted to find the optimal treatment for these cases.</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":"120 5","pages":"603-606"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145450641","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}