Objective: To investigate the effect of endometrial abnormalities in breast cancer patients treated with Tamoxifen (group I), Aromatase inhibitors (group II) or No treatment (group III) .To determine the best approach for screening these patients for endometrial pathology. Methods:117 patients at outpatient clinic, Departments of Clinical Oncology& Nuclear medecine and of Obstetrics & Gynecology, Zagazig University Hospitals .Conventional transvaginal ultrasonography for detection of the uterine size, endometrial thickness as basal ultrasound and followed up every six months. Diagnostic hysteroscopy and endometrial biopsy were done only for patients with abnormal uterine bleeding and asymptomatic patients with increasd endometrial thickness >5mm in postmenopausal or >8mm in premenopausl cases. Results: At the end of 48 months follow up period, the most common endometrial lesions of group I were endometrial hyperplasia in 5 patients (31.3%),endometrial polyp in 4 patients (25 %) and endometrial atrophy in two patient (12.5%). This gave impression that endometrial poylp & endometrial hyperplasia were the most common endometrial lesion of group I. In group II the most common endometrial lesions detected by hysteroscopy and histopathological examination were endometrial atrophy in 3 patients (30%), endometrial polyp in one patient (10%) and endometrial hyprplasia in one patient (10%). Conclusions: Tamoxifen was associated with development of various endometrial changes, including endometrial hyperplasia, cystic atrophy, leiomyoma, endometrial carcinoma and other types of uterine malignancy especially in postmenopausal patients. Even if they are asymptomatic, these patients must be evaluated carefully. B Ahmed et al….

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Background: This study Assess the frequency and nature of intraoperative and postoperative complications as well as short term outcomes in ovarian cancer patients treated with open surgery including para-aortic lymph node dissection (PALND). Methods: This descriptive cross-sectional study enrolled 36 patients underwent PALND up to the renal vessels as a part of open surgery for suspected early and advanced stages of ovarian cancer in Obstetrics and Gynecology Department, Zagazig University Hospitals, Egypt, during the period from August 2015 to November 2017. Results: In this study, the duration of PALND itself is more or less than one hour (mean 66.1±13.7 and range 45-80 m) and the median volume of blood loss was (105 ml). 8 patients (22.2%) received intra and postoperative blood transfusion, the range of hospital stay for all patients was (7-14) days. the rate of postoperative ICU admission was (16.6%). There were no postsurgical treatment-related deaths. The most frequent postoperative complications were ileus (8.3%), LL lymphatic edema (8.3%) and major wound healing complications (11.1%). Conclusion: ovarian cancer patients may safely undergo comprehensive staging involving PALND in open surgeries without significant perioperative morbidity, if provided by trained Gynaeoncologists.

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Objective: The aim of the work is to investigate whether minilaparotomy hysterectomy for benign uterine lesions might be a reasonable alternative to laparoscopic hysterectomy in terms of operative and postoperative short-term outcomes. Methods: 105 patients scheduled to undergo total hysterectomy for a benign uterine lesion were divided into 3 groups according to their selection of the method of intervention after counseling: Group A (35 patients) minilaparotomy hysterectomy using conventional sutures.Group B (35 patients) minilaparotomy hysterectomy using bipolar vessel sealing system (Ligasure).Group C (35 patients) laparoscopic hysterectomy using Ligasure. Result(s): The operating time in Group A (84.7  9.9 minutes), group B (55.3  7.8 minutes), while group C ( 94.8  16 minutes).The duration until resumption of intestinal sounds in group C (12.3  2.5 hours) in comparison to group A (17.4  1.9 hours) and group B (16.5  1.76 hours). Blood loss in group B (99.1 ± 30.8 ml) ,group A (130.3 ± 54.4 ml) and group C (136.6 ± 6.6 ml). The longest hospital stay occurred in group A (31.8 ± 5.7 hours) versus groups B (20.7 ± 2.5 hours) and C (19.3 ± 6 hours). The highest pain score was observed in group A (5.2 ± 1.1) versus groups B (3.8 ± 1.6) and C (3.7 ± 1.2).There was no significant difference in the incidence of intraoperative or postoperative complications. Conclusion(s):The use of ligasure bipolar vessel sealing system in minilaparotomy hysterectomy was associated with less operative time and intraoperative blood loss, while it was comparable to laparoscopic hysterectomy in hospital stay and postoperative pain scoring with low morbidity and a short hospital stay. It may be a suitable alternative to laparoscopic hysterectomy which is ideal in areas which lack high laparoscopic experience or facilities.