Objective. Aim of this current study was to assess benefits, role, safety and outcomes of secondary surgery (SS) followed by chemotherapy in comparison with using chemotherapy alone in EOC patient presented with isolated lymph node recurrence (ILNR). Patients and Methods. This study included 25 EOC patients who presented with ILNR underwent secondary surgery followed by chemotherapy and 35 EOC patients who presented with ILNR and treated with chemotherapy alone. We collected clinical, surgical, pathological and follow-up data and compared between both groups of patients regarding outcome, recurrence and survival rates. Results. Favorable RFS and OS rates were found to be associated with the type of treatment (SS followed by chemotherapy versus chemotherapy alone p = 0.036 and p = 0.049 respectively). Patients who underwent SS followed by chemotherapy had a 75% reduction in recurrence related death risk and an 80% reduction in general death risk after primary diagnosis in comparison with those who received only chemotherapy without SCS. Conclusions. We concluded that SS in addition to chemotherapy in selected ovarian cancer patients presented with ILNR was associated with a more favorable outcome than using chemotherapy alone.

Objective. A reported complication after total laparoscopic hysterectomy (TLH) is vaginal cuff infection (VCI) that needs readmission, antibiotic therapy and worsen post-operative quality of life in patients. Another bad complication of TLH is occurrence of vaginal cuff dehiscence (VCD), which is the separation of sutured vaginal incision. Identification of possible risk factors of VCI and VCD after TLH could help in reducing such annoying complications of patients and health care system. Aim of the present work was assessment of prevalence, preoperative, operative and postoperative risk factors of VCI and VCD after performing TLH for treatment of benign pathological uterine conditions in Egyptian patients. M a n u s c r i p t a c c e p t e d f o r p u b l i c a t i o nPatients and Methods. We conducted this prospective cohort study and included 200 females with clinical and radiological evidence of benign pathological conditions in the uterus that underwent TLH. We followed up all patients for 6 weeks post-operatively by performing full gynecological examination in addition to transvaginal sonography then followed up by telephone to assess occurrence of VCI or VCD.Results. 14 of the 200 included patients (7%) were diagnosed with VCI and 8 of the 200 included patients developed VCD (4%) during the 30 days after TLH.There is statistically significant relation between occurrence of vaginal cuff infection and specimen weight, high CRP, vaginal cuff hematoma, complications, suturing technique (p<0.001).There is statistically significant relation between occurrence of vaginal cuff dehiscence and specimen weight (lower with dehiscence) and vaginal cuff hematoma (associated with dehiscence) (p<0.001).Conclusions. We concluded that high post-operative CRP level and occurrence of postoperative vaginal cuff hematoma without sufficient prophylactic antibiotic therapy were significant risk factors of VCI while smaller uterine size is a predictor risk factor of VCD.