Urachal cancer is very rare, accounting for only 0.5–2% of bladder-associated malignancies and 0.01% of all cancers in adults. It has an insidious appearance, an aggressive behavior and a poor prognosis. The most common symptoms are hematuria and the presence of a palpable hypogastric mass. The scarcity of cases and the low number of studies carried out explains the lack of an evidence-based management strategy, but it seems that surgical treatment (open, laparoscopy or robot-assisted) represents the gold standard, while neoadjuvant and adjuvant chemotherapy or radiotherapy has a limited impact on overall survival. Since mucinous cystadenocarcinoma of urachal origin is a very uncommon pathological condition the differential diagnosis may be difficult and pathological investigations have to elucidate this disorder. It is worth mentioning the psychological impact on the patient in addition to the medical aspects. A rare condition is associated with heightened risk for mental health and psychosocial difficulties and this must be taken into account in the subsequent follow-up of the patient. In order to increase awareness of this rare entity we report a case of a 40-year-old male with a urachal adenocarcinoma who was treated surgically, with a favorable outcome. We also perform a brief literature review about this type of tumor.

Hiatal hernia is a complex pathology, associated with gastroesophageal reflux disease, and for which management involves complex surgical treatment. Knowing the role of gastropexy in reducing postoperative recurrences, the current study aimed to highlight the intraoperative advantages and results of this surgical technique. Our study includes 29 patients aged between 34 and 84 years. Regarding the mechanism of occurrence, two thirds of the patients presented with mixed hiatal hernias (65.52%), 31.03% with sliding hiatal hernias, and 3.45% with paraesophageal hiatal hernias. The hernia size played a decisive role in the choice of surgical procedure, whereby for large hernias (with a diameter of over 7 cm), the Nissen procedure associated with gastropexy was preferred. For hernias with a diameter of less than 7 cm, the Nissen procedure associated with hernia orifice repair was performed. For hernias between 5 and 6 cm, gastropexy was also performed. Statistical analysis revealed a close correlation between the surgical procedure and the hernia size, with p = 0.005. Out of a total of 29 patients, 18 patients had gastropexy and 11 were without gastropexy. The association of gastropexy does not increase hospitalization costs, but in the long term, it has the advantage of reducing relapse.

Hiatal hernia is a complex pathology, associated with gastroesophageal reflux disease, and whose management involves complex surgical treatment. Knowing the role of gastropexy in reducing postoperative recurrences, the current study aimed to highlight the intraoperative advantages and results of this surgical technique. Our study includes 29 patients, aged between 34 to 84 years. Regarding the mechanism of occurrence, two thirds of the patients presented with mixed hiatal hernias, 31.03% with sliding hiatal hernias and 3.45% with paraesophageal hiatal hernias. The hernia size played a decisive role in the choice of surgical procedure, for large hernias (with a diameter of over 7 cm) the Nissen procedure associated with gastropexy was preferred.For hernias with a diameter of less than 7 cm, the Nissen procedure associated with hernia orifice repair was performed. For hernias between 5 and 6 cm, gastropexy was also performed. The association of gastropexy does not increase hospitalization costs, but in the long term it has the advantage of reducing relapse.