Background: To report the surgical outcomes of laparoscopic resection of large adnexal masses (≥10 cm). Methods: In this cross-sectional study, we enrolled 126 patients with large adnexal masses (≥10 cm), managed by laparoscopic surgery during 2013 to 2020. The rates of intraoperative complications, conversion to open surgery and incidence of cancer were assessed.Results: Mean mass size was 15.08±5.03 in all participants without significant difference based on the tumor type (P=.624). Mean age and operation time were higher in the malignant type compared to that of the benign type (P<.001). Type of surgery and frequency of intra-operative complications were also different among patients with different tumor types (P<.001 and .003, respectively).Conclusion: Our study showed that large adnexal tumors can be operated by laparoscopic approach, while the most important factor for increased surgical complications and duration was malignancy.

Introduction: Emotional divorce happens when a man and a woman live coldly together but do not request a legal divorce. So the aim of this study is to investigate the impact of acceptance and commitment group therapy (ACT) on emotional divorce and self-efficacy of couples. Methods: This was a experimental study with a control group. The statistical population consisted of 338 married people working in an industrial factory in Bu Ali town of Hamedan province in 2020. After distributing an emotional divorce questionnaire, authors selected 60 people with emotional divorce problems. Then, 40 people who had obtained average scores in the self-efficacy questionnaire were selected as the sample and were randomly divided into experimental and control groups. The experimental group received acceptance and commitment-based treatment for 8 weeks, but the control group did not receive any intervention. Research instruments were Gottman's Emotional Divorce Questionnaire (1994) as well as self-efficacy questionnaire of Scherer et al., (1982) used as a pre-test-post-test. SPSS version 23 software was used for data analysis Shapiro-Wilk test was used to evaluate the normality of the distribution of the variables. According to the level of significance (P <0.05) of the variables of emotional divorce and self-efficacy, the normality of the distribution of scores in the experimental and control groups is confirmed. Leven's test was used to examine the presumption of variances' equality of the two groups in the population. Results: The results of analysis of covariance showed that acceptance and commitment group treatment reduced the scores of emotional divorce (p <0.05) and increased self-efficacy (p <0.05) in the experimental group compared to the control group in the post-test phase. The results of Leven test for the emotional divorce variable (P = 0.414, F = 0.682) and self-efficacy variable (P = 0.601, F = 0.278) confirmed variances' equality Conclusions: Acceptance and commitment group therapy was able to significantly reduce emotional divorce and increase self-efficacy compared to the control group. Therefore, it is possible to prevent acceptance and commitment therapy to reduce emotional divorce and prevent psychological and social damage.

Background: Adnexal mass is one of the most common gynecologic diseases among women of all ages. Methods: In this cross-sectional study, we enrolled 126 patients with large adnexal masses (≥ 10 cm) managed by laparoscopic surgery during 2013 - 2020. The rates of intraoperative complications, conversion to open surgery, and incidence of cancer were assessed. Results: Mean mass size was 15.08 ± 5.03 in all participants without significant difference based on the tumor type (P = 0.624). Mean age and operation time were higher in the malignant type compared to the benign type (P < 0.001). Type of surgery and frequency of intraoperative complications were also different among patients with different tumor types (P < 0.001 and P = 0.816, respectively). Conclusions: Our study showed that large adnexal tumors can be operated by laparoscopic approach, while the most important factor for increased surgical complications and duration was malignancy.