Ectopic pregnancies are a frequently encountered cause of first-trimester metrorrhagia. They occur when an embryo is implanted and grows outside the normal uterine space. Uncommonly, the embryo can be implanted in the intramural portion of the uterine tube, a condition referred to as interstitial localization. This specific type of ectopic pregnancy may have an unpredictable course, potentially leading to severe uterine rupture and catastrophic bleeding if not promptly diagnosed and managed. We present a rare case of a multiparous 36-year-old female patient who underwent pelvic ultrasonography in the emergency department for intense pelvic pain associated with hypotension and moderate anemia. A history of right salpingectomy for a ruptured tubal ectopic pregnancy 10 years previously was noted. High beta-HCG levels were also detected. A pelvic ultrasound allowed us to suspect a ruptured ectopic interstitial pregnancy at 8 weeks of amenorrhea. An association with hemoperitoneum was suspected, and an emergency laparoscopy was performed. The condition was confirmed intraoperatively, and the patient underwent a right corneal wedge resection with suture of the uterine myometrium. The postoperative course was uneventful, and the patient was discharged on the fourth day postoperatively. Interstitial ectopic pregnancy is a rare yet extremely perilous situation. Timely ultrasound-based diagnosis is crucial as it can enable conservative management with Methotrexate. Delayed diagnosis can lead to uterine rupture with consecutive surgery based on a transection of the pregnancy and cornual uterine resection.

Background: Incisional hernias are a frequent complication after abdominal surgery and may significantly affect patient outcomes. Retromuscular mesh placement using the Rives–Stoppa technique is widely considered a reliable approach for abdominal wall reconstruction, although postoperative complications remain an important clinical concern. Identifying predictors of adverse outcomes may improve patient selection and perioperative management. Methods: This retrospective cohort study included 1262 patients who underwent retromuscular incisional hernia repair. Demographic characteristics, comorbidities, hernia features, operative data, and postoperative outcomes were analyzed. Univariate and multivariable logistic regression analyses were performed to identify independent predictors of postoperative complications. Model performance was evaluated using receiver operating characteristic analysis. Results: The study included 1262 patients with a mean age of 61.5 ± 12.4 years, with a slight predominance of women (55%). The overall complication rate was 19.5%, with seroma (10.5%), surgical site infection (7.0%), and hematoma (3.5%) being the most common events. Hernia recurrence occurred in 6.0% of patients during follow-up. Multivariable analysis identified obesity (p < 0.001), large defect size (W3) (p < 0.001), diabetes mellitus (p = 0.004), recurrent hernia (p = 0.013), and ASA III–IV status (p = 0.038) as independent predictors of postoperative complications. The predictive model demonstrated moderate discrimination (AUC ≈ 0.73). Conclusions: Retromuscular incisional hernia repair is associated with acceptable morbidity and low recurrence rates. Obesity (OR 2.41), large defect size (W3) (OR 2.12), diabetes mellitus (OR 1.89), recurrent hernia (OR 1.67), and American Society of Anesthesiologists (ASA) classification III–IV status (OR 1.54) were identified as independent predictors of postoperative complications. The predictive model demonstrated moderate discrimination (AUC ≈ 0.73), supporting its potential role in clinical risk stratification and perioperative decision-making.

Background: Elective surgery soon after SARS-CoV-2 infection is linked to high morbidity, but the risk > 7 weeks post-infection is uncertain. Methods: A PROSPERO-registered systematic review (CRD42023416842) following PRISMA 2020 searched PubMed, Web of Science, WHO COVID Database, Wiley, Google Scholar, and Scopus (Jane 2020–July 2025) for studies reporting postoperative outcomes in patients with confirmed COVID-19 ≥ 7 weeks before elective surgery. Primary endpoints were cardiopulmonary, neurological, renal and thrombotic complications, ICU/hospital stay and 30-day mortality. Results: Thirteen observational studies (38,055 patients) met inclusion criteria. In patients operated ≥7 weeks after mild or asymptomatic infection, overall mortality rate was 2.27% (607/26,688), with no significant excess versus uninfected controls. Pneumonia (1.66%), pulmonary embolism (1.47%), arrhythmias (2.57%) and myocardial injury (1.06%)—did not exceed baseline surgical rates. Thrombosis occurred in 2.8% but lacked a clear association with prior infection. Conversely, individuals with previous moderate-to-severe disease or recent COVID-19-related hospitalization showed higher complication rates, especially in complex procedures such as coronary bypass. Conclusions: Evidence to date indicates that COVID-19 history beyond seven weeks does not independently raise perioperative morbidity or mortality for most elective procedures.

Background/Objectives: Quality of life (QoL) and functional recovery are essential outcomes in patients undergoing rectal cancer surgery. In addition to oncological results, bowel dysfunction and stoma-related issues may significantly affect postoperative well-being. We aimed to evaluate QoL changes at 1 and 6 months postoperatively and functional outcomes in rectal cancer patients who underwent curative surgical treatment, sphincter-preserving surgeries (SPS) or abdominoperineal resection (APR). Owing to its impact on QoL, several functions were assessed using the Low Anterior Resection Syndrome (LARS) score. Methods: This retrospective observational study consisted of 99 patients who underwent curative rectal cancer surgery, of which 38 patients had colostomy, and 61 no colostomy. To assess patient-reported outcomes related to QoL, the EORTC QLQ-C30 questionnaire, QLQ-CR29 questionnaire, and LARS instrument were sent to the patients at 1 and 6 months postoperatively. Changes over time were analyzed using paired statistical tests, and subgroup analyses were performed according to colostomy status and surgical approach. Results: Significant improvements were observed in the global health status and all major functional domains between 1 and 6 months postoperatively. The global health status increased from 74.9% to 86.5% (p < 0.001). Symptom burden decreased significantly, particularly for fatigue (−18.31), pain (−14.48), diarrhea (−12.46), and insomnia (−11.45), representing clinically meaningful improvements. Patients who underwent abdominoperineal resection or resection with colostomy had lower QoL scores at 1 month but showed substantial improvement at 6 months, becoming comparable to those who underwent SPS. LARS outcomes demonstrated progressive functional recovery, with the proportion of patients without LARS increasing from 39 to 46, while major LARS decreased from 7 to 3 patients. However, approximately 40% of patients in the SPS group continued to report moderate-to-severe LARS symptoms. Conclusions: In this study, QoL and bowel function improved significantly during the first 6 months after colorectal cancer surgery. Although most patients demonstrated recovery, persistent bowel dysfunction and stoma-related challenges remain important issues. These findings highlight the need for comprehensive postoperative care and routine assessment of both QoL and functional outcomes.

Cryptorchidism is defined as the extra-scrotal position of the testes. It is a common disorder in male children, but rarely in adult patients. The association of cryptorchidism with hernia is a common finding in childhood, but is not frequent in adults or the elderly. Herein, we report a series of three cases (28-, 24-, and 34-year-old men) of adult inguinal hernia combined with cryptorchidism successfully managed by laparoscopic surgery under the same operative view. Laparoscopic transabdominal preperitoneal repair and orchiectomy were performed in all patients. No complications occurred in the postoperative period, and the patients were discharged on the first or second postoperative day. Pathological examination of the specimens revealed atrophic testes without malignancy. No hernia recurrence was observed during follow-up. The laparoscopic approach in the combined pathology of inguinal hernia and cryptorchidism is feasible in adult patients and has multiple advantages in terms of diagnosis and management.

Background: Hysterectomy is one of the most common gynecological surgical procedures for benign conditions. In clinical practice, the choice of approach is often influenced by technology availability, leading to selection bias rather than to a decision based on standardized clinical criteria. The study aims to propose a standardized decision-making algorithm, based on objective clinical criteria, for selecting the surgical approach in total hysterectomy. Methods: This is a prospective, observational, analytical study conducted from November 2021 to June 2025, including a cohort of 332 patients who underwent total hysterectomy (LH, VH, AH) for benign gynecological pathology at two major centers in Bucharest. We proposed a decision algorithm based on the results obtained from predictive modelling and the quantified risk factors. Results: The choice of surgical approach is a critical factor in hematological stability, and the presence of comorbidities was associated with the type of approach (p < 0.001). Patients without comorbidities predominantly benefited from laparoscopy (48.85%), but as the anesthetic risk increased (ASA III and IV), the vaginal or abdominal routes were preferred. Conclusions: The convergence of these elements suggests that such a tool can standardize therapeutic decisions and improve the efficiency of interventions, offering a modern and predictable framework for gynecological surgery.