Preoperative Angiography and Transarterial Embolization in the Management of Carotid Body Tumor: A Single-Center, 10-Year Experience

Abstract BACKGROUND: Sixty percent of paragangliomas are located unilaterally at the carotid bifurcation. These are referred to as carotid body tumors (CBTs). OBJECTIVE: To present our 10-year experience in the management of patients with CBTs, and to evaluate the efficacy of angiography and preoperative embolization technique in this retrospective study. METHODS: Sixty-two patients with surgically removed CBTs (Shamblin class II and III), were divided into two groups. Group I, the preoperative embolization group, included 33 patients with 11 class II lesions and 25 class III lesions. Group II, the group that had surgery only, without preoperative embolization, included 29 patients with 9 class II lesions and 21 class III lesions. Comparisons were made between the groups in terms of mean intraoperative blood loss, mean operation time, mean postoperative hospital stay, and clinical complications. RESULTS: In group I, post-embolization angiography demonstrated complete tumor devascularization in 25 (76%) lesions and partial devascularization in 11 (24%) lesions. All but 1 (2%) lesion were completely excised. Mean intraoperative blood loss, mean operation time, and mean hospital stay were 354.8 ± 334.4 mL, 170.3 ± 75.4 min, 8.0 ± 2.1days in group I and 656.4 ± 497.4 mL, 224.6 ± 114.0 min, 9.5 ± 3.5days in group II, respectively. In group II, 27 lesions (91%) were completely removed. The transient ischemic attack (TIA) and cranial nerve injury incidence rates were 10.3% and 13.8% in group II and only 3% for TIA in group I. CONCLUSION: These results suggest angiography is highly valuable for the diagnosis of CBT. Preoperative selective embolization of CBT is an effective and safe adjunct for surgical resection, especially for Shamblin class II and III tumors.

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Percutaneous endoscopic treatment of benign and malignant renal pelvis carcinoma: A single-center experience

10.21203/rs.3.rs-41645/v1 ◽

2020 ◽

Author(s):

Xin Zhang ◽

Wu Xiu Han ◽

Sheng Yan Li ◽

Hao Yuan Chen ◽

Zhe Yu Tang ◽

...

Keyword(s):

Blood Loss ◽

Hospital Stay ◽

Renal Pelvis ◽

Operation Time ◽

Laser Evaporation ◽

Pathological Grade ◽

Group I ◽

Grade Ii ◽

The Mean ◽

Group Ii

Abstract Background Percutaneous nephrolithotomy (PCNL) is a safe and efficient treatment for intro-renal diseases, most of which are calculus disease. In this study, we carried out percutaneous endoscopic nephron-sparing ablation for renal carcinoma in carefully selected patients. Our aim was to evaluate whether percutaneous endoscopic nephron-sparing operation was feasible for patients with renal cell carcinoma.Methods A total of 15 patients with renal pelvis carcinoma were treated with laser evaporation under percutaneous endoscopy between January 2015 and September 2019 ( group I ). Another 13 patients who received standard radical nephroureterectomy were recruited as the control group (group II). We recorded demographic data of the patients, the indication for surgery, tumor pathological grade, size and side of tumor, and the intraoperative and postoperative outcome, including the duration of surgery, length of hospital stay, and complication rate, as well as progression-free survival (PFS).Results In both groups, all of the patients received flexible ureteroscopy. In group I, 14 patients had transitional renal cell carcinoma (UCC), four had pathological grade I, nine had grade II, and one had hemangiopericytoma. In group II, all patients had UCC, five had pathological grade I, and eight had grade II. In group I, the mean operation time was 118 min (65–236 min), the mean blood loss was 110 ml (55–220 ml), and the mean hospital stay was 9 days (7–12 days). During follow-up, two patients died and two had recurrence; among them, one had systematic bone metastasis. The PFS rate was 66.7% (10/15). In group II, the mean operation time was 265 min (185–436 min), the mean blood loss was 133 ml (85–240 ml), and the mean hospital stay was 13 days (9–16 days). During the follow-up, two patients died and there was no local or systematic metastasis. The PFS rate was 84.6% (11/13). There was no significant difference in blood loss between the groups. However, the operation time and mean hospital stay were significantly shorter in group I compared with that in group II ( P < 0.05). But the PFS rate was significantly higher in group II than in group I (P < 0.05).Conclusions This study shows that laser evaporation under percutaneous endoscopy for renal pelvis carcinoma is a safe, effective, and technically feasible procedure for treating benign and malignant renal pelvis carcinoma.

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Comparison of early clinical results for the femoral neck system and cannulated screws in the treatment of unstable femoral neck fractures

10.21203/rs.3.rs-129837/v2 ◽

2021 ◽

Author(s):

Xiaoqiang Zhou ◽

Zhiqiang Li ◽

Renjie Xu ◽

Yuanshi She ◽

Xiangxin Zhang ◽

...

Keyword(s):

Femoral Head ◽

Femoral Neck ◽

Blood Loss ◽

Hospital Stay ◽

Clinical Efficacy ◽

Operation Time ◽

Femoral Neck Fractures ◽

Femoral Head Necrosis ◽

Cannulated Screws ◽

Intraoperative Blood Loss

Abstract Objective: To compare early clinical effects of the femoral neck system (FNS) and three cannulated screws for the treatment of patients with unstable femoral neck fractures.Methods: A retrospective analysis with pair matching of 81 patients who received FNS or cannulated screw internal fixation for Pauwels type-3 femoral neck fracture in our hospital from January 2019 to December 2019 was conducted. Patients who received FNS were the test group, and those who received cannulated screws comprised the control group. Matching requirements were as follows: same sex, similar age and similar body mass index (BMI). A total of 30 pairs were successfully matched, and the average age was 53.84 years. The operation time, intraoperative blood loss, hospital stay, hospitalization cost, postoperative visual analogue scale (VAS) score, time to walking without crutches, Harris score, femoral head necrosis rate and complication rate were compared between the groups.Results: Postoperative re-examination of radiographs showed satisfactory reduction in all patients, and all patients were followed up for 10-22 months. Those in the FNS group had lower postoperative VAS scores, earlier times to walking without crutches, higher Harris scores at the last follow-up and lower complication rates (P<0.05). However, intraoperative blood loss and hospitalization costs were greater in the FNS group (P<0.05). No statistically significant difference in operation time, hospital stay or femoral head necrosis rate was observed between the two groups (P>0.05).Conclusion: For patients with unstable femoral neck fractures, FNS has better clinical efficacy than cannulated screws, though it is also more expensive. The excellent biomechanical performance and clinical efficacy of FNS make it a new choice for the treatment of unstable femoral neck fractures.

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Sex specificities of medical and social parameters in patients with coronary artery disease with different severity of depression

CARDIOVASCULAR THERAPY AND PREVENTION ◽

10.15829/1728-8800-2021-2425 ◽

2021 ◽

Vol 20 (1) ◽

pp. 2425

Author(s):

Yu. V. Nagibina ◽

M. I. Kubareva ◽

D. S. Knyazeva

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Class Ii ◽

Mental Condition ◽

Class Iii ◽

Group I ◽

Severity Of Depression ◽

The Mean ◽

Group Ii ◽

Artery Disease

Aim. To determine the sex specificities of medical and social parameters in patients hospitalized due to coronary artery disease (CAD), class II, III, IV angina, aged 35-60 years and assess the significance of their relationship with different levels of depression.Material and methods. The study involved 312 patients aged 35-60 with documented CAD, class II, III, IV angina. Two comparison groups were identified: group I — 138 patients (men, 81; women, 57) with CAD and without depression (mean age, 47,8±4,6 years); group II — 174 patients (men, 60; women, 105) with CAD and depression (mean age, 48,3±5,3 years). Medical and social data, the severity of depression and distress tolerance, psychological status and quality of life was assessed. Statistical analysis was carried out, which are presented as the mean and standard error of the mean (M±m). The odds ratio (OR) and 95% confidence interval (CI) were calculated. Differences were considered significant at p<0,05.Results. The prevalence of depression among patients with CAD was 55,77%, while women were 1,5 times more likely to suffer it than men. Depression was significantly associated with hyperglycemia, hypercholesterolemia, and class III-IV angina, regardless of sex. Class III and IV angina prevailed in women, while class II angina — in men (OR, 2,16; 95% CI, 1,37-3,41, p<0,001)). Women were more prone to degree II-III disability (group II, 26,67%; group I 8,77%; p=0,008), compared with men (group II, 27,54%; group I, 11,11%; p=0,012). Sedentary lifestyle was also associated to a greater extent with the female sex than with the male (OR, 2,89, 95% CI, 1,46-5,70, p=0,003; OR, 2,31, 95% CI, 1,19-4,48; p=0,014, respectively). Both men and women showed a significant association of depression with atherosclerosis (p<0,001), however, sex differences did not reach significance. Indicators such as lack of job and higher education, as well as smoking and arrhythmias were characteristic of both sexes, but had a greater impact on the mental condition of men (p=0,002, p<0,001, p=0,0014 and p=0,01, respectively). For men, the relationship of depression with diabetes (8,7 vs 0%; p=0,008), obesity (42,03 vs 19,75%; p=0,004), subordinate status (82,61 vs 64,2%; p=0,016) and unmarried status (60,87 vs 40,74%; p=0,02).Conclusion. There are significant differences in factors contributing to depression in different sex groups. The association of depression with CAD has an adverse effect on the physical and psychological health of both males and females. At the same time, women are more prone to mental disorders than men. It is necessary to further study the sex characteristics of medical and social parameters in order to personalize treatment methods.

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Comparison of Perioperative Outcomes in Open and Laparoscopic Radical Cystectomy with Modified Ureterosigmoidostomy (MainzII): A Retrospective Analysis

10.21203/rs.3.rs-805660/v1 ◽

2021 ◽

Author(s):

Bin Zhang ◽

Yang He ◽

Duo Zheng ◽

Junyao Liu ◽

Peng Qi ◽

...

Keyword(s):

Blood Loss ◽

Hospital Stay ◽

Radical Cystectomy ◽

Urinary Diversion ◽

Open Surgery ◽

Operation Time ◽

Laparoscopic Group ◽

Postoperative Hospital Stay ◽

Intraoperative Blood Loss

Abstract Background: To analyze perioperative conditions and long-term efficacy of open modified ureterosigmoidostomy urinary diversion (OMUUD) in patients with bladder cancer who underwent open radical cystectomy (ORC) and laparoscopic radical cystectomy (LRC).Methods: In this retrospective study, the clinical data of patients who underwent open and laparoscopic radical cystectomy plus open modified ureterosigmoidostomy urinary diversion in our hospital were collected from January 2011 to December 2019. In addition, perioperative data of 56 patients who underwent ORC and OMUUD were compared with those of 118 patients who underwent laparoscopic radical cystectomy (LRC) plus OMUUD. A long-term follow-up was performed to compare the overall survival (OS) and progression-free survival (PFS) rate between the two groups.Results: Results showed that there was no significant difference between ORC+OMUUD group and LRC+OMUUD group in terms of gender, age, body index, pre-operative ASA grade, history of transurethral resection of bladder tumor (TURBT) before surgery, tumor T stage, lymph node dissection range, pathological grade, and positive postoperative surgical margin. The mean operation time in the open group was shorter than that in the laparoscopic group （P<0.001）. Moreover, the estimated intraoperative blood loss（P<0.001）and postoperative hospital stay（P=0.023）were better in the laparoscopic group than in the open group. The incidence of complications between 30 days (P=0.665) and 90 days (P=0.211) time-points after surgery was not significantly different. Similarly, the OS (P=0.237) and PFS (P=0.307) between the two groups were comparable.Conclusion: This study shows that the LRC group has long operation time, but less estimated intraoperative blood loss, short postoperative hospital stay, small trauma, and fast postoperative recovery compared to open surgery. Moreover, the incidence of complications at 30 - and 90-days postoperation, as well as the OS and PFS is not different between laparoscopy and open surgery.

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Endoscopic interlaminar lumbar discectomy: How to decrease the learning curve

Surgical Neurology International ◽

10.25259/sni_588_2020 ◽

2020 ◽

Vol 11 ◽

pp. 401

Author(s):

Sherif Elsayed Elkheshin ◽

Ahmed Y. Soliman

Keyword(s):

Blood Loss ◽

Learning Curve ◽

Operative Time ◽

Lumbar Disc ◽

Standard Technique ◽

Intraoperative Blood Loss ◽

Modified Technique ◽

Group I ◽

Herniated Lumbar Disc ◽

Group Ii

Background: Herniated lumbar disc is a common cause of lumbosacral pain. Endoscopic interlaminar lumbar discectomy (ILD) is a well-established technique that provided comparable results to micro-discectomy. The aim of the study is to describe the learning curve of endoscopic ILD and explore measures that could improve effectiveness and decrease blood loss and operative time with accumulation of reasonable experience. Methods: This retrospective cohort study included 65 patients presenting with symptomatic herniated lumbar disc who underwent endoscopic ILD. Patients were divided into two groups: Group I (standard technique) and Group II (modified technique). Collected data included patients’ age, gender, preoperative manifestations, visual analog score (VAS) for pain, Oswestry Disability Index (ODI), disc level, operative time, intraoperative blood loss, complications, and follow-up data at 1, 6, and 12 months postoperatively. Primary outcomes included total operative time, amount of intraoperative blood loss, and post-operative improvement in pain. Secondary outcomes included intraoperative complications, rate of conversion to open surgery, and recurrence. Results: Post-operative VAS and ODI improved significantly in both groups. Mean total surgical time and intraoperative blood loss were significantly lower in Group II compared to Group I (P < 0.001). The learning curves for operative time and intraoperative blood loss were shallow in Group I, and almost flattened in Group II. Complications were recorded in only three cases, and no symptomatic recurrences were reported. Conclusion: The learning curve of endoscopic ILD was shallow with standard technique, indicating difficulties in mastering the procedure. The proposed modified technique helped reaching the required level of proficiency in the early phase of the curve, providing a significant reduction in operative time and blood loss, with comparable effectiveness and safety as the standard technique.

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Efficacy of Preoperative Misoprostal in Reducing Hemorrhage during Abdominal Myomectomy

10.53350/pjmhs211561934 ◽

2021 ◽

Vol 15 (6) ◽

pp. 1934-1936

Author(s):

Irum Batool Hashmi ◽

Asim Shafi ◽

Ayesha Choudhary ◽

Wasim Ahmad ◽

Muhammad Hamayun Khan ◽

...

Keyword(s):

Body Mass Index ◽

Blood Transfusion ◽

Blood Loss ◽

Body Mass ◽

Intraoperative Blood Loss ◽

Abdominal Myomectomy ◽

Group I ◽

Group Ii ◽

One Year ◽

Double Blinded

Objective: The aim of this study is to determine the efficacy of preoperative misoprostal in reducing hemorrhage during abdominal myomectomy. Study Design: Prospective comparative randomized double blinded Place and Duration: Conducted at DHQ Zanana hospital Dera Ismail Khan for one year duration from January 2019 to December 2019. Methods: Total 100 patients underwent abdominal myomectomy were presented in this study. Patients were aged between 18-45 years of age. Patients’ detailed demographics including age, body mass index and parity were recorded after taking informed written consent. Patients were categorized equally into two groups, I and II. Group I had 50 patients and received single dose 400 micrograms of misoprostol transrectally one hour preoperatively and group II had 50 patients and received 2-tablets of placebo preoperatively. Outcomes intraoperative blood loss, blood transfusion, hysterectomy and complications among both groups were assessed. Complete data was analyzed by SPSS 23.0 version. Results: Mean age of the patients was 32.16±9.44 with mean BMI 26.07±10.44 kg/m2. There were no significantly difference among age and body mass among both groups. 60 Patients had 0 parity, 30 patients had parity 1 and the rest were had parity 2. Mean pre-operative hemoglobin in group I was 13.64±8.55 and post-operative was 9.88±8.55 and in group II mean pre-operative hemoglobin was 13.55±8.55 and post-operative was 9.12±5.55. Mean intraoperative blood loss in group I was 388.17±37.18 ml and in group II was 501.16±17.64 ml. Post-operatively blood transfusion in group I was among 2(4%) cases and 3 (6%) in group II. Mean hospital stay in group II was greater as compared to group I. Nausea, vomiting and shivering were the complications found in this study. Conclusion: We concluded in this study that the use ofmisoprostol preoperatively during abdominal myomectomy was effective safe and useful in reduction of intraoperative blood loss and post-operatively blood transfusion among patients. Keywords: Abdominal myomectomy, Misoprostol, Placebo, Intraoperative, Blood loss

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Outcomes of Open Cystolithotomy and Percutaneous Cystolithotripsy in the Management of Urinary Bladder Stone

Journal of Nepalgunj Medical College ◽

10.3126/jngmc.v19i2.40041 ◽

2022 ◽

Vol 19 (1) ◽

pp. 1-4

Author(s):

Naresh Man Shrestha

Keyword(s):

Urinary Bladder ◽

Hospital Stay ◽

Operation Time ◽

Bladder Stone ◽

Medical College ◽

Group I ◽

Stone Free Rate ◽

Urinary Tract Stone ◽

Group Ii ◽

Free Rate

Introduction: Urinary bladder stone occupies only 5% of all urinary tract stone. Various techniques have been used for the management of bladder stone. Open Cystolithotomy is the traditional treatment but a percutaneous approach has been also in practice. Aims: To confirm the best options between open cystolithotomy and percutaneous cystolithotripsy for the treatment of bladder stone. Methods: It is a prospective hospital based study from May 2019 to January 2021 in Nepalgunj Medical College. Total 42 patients with inclusion criteria were divided into two groups. Group I was allocated to 21 patients who were treated with open cystolithotomy while Group II were allocated to 21 patients who were treated with percutaneous cystolithotripsy. Two groups were compared for stone free rate, mean hospital stay, mean postoperative scar, mean operation time and rate of post-operative complications. Results: The stone free rate in Group I was 100 % and in Group II was 90.47 %. Mean Operation time was in Group I and Group II were 40.09+ 2.48 minutes and 31.38+15.65 days, respectively with p<0.05. Mean hospital stay was significantly low in Group II (3.71+1.87 days ) when compared to Group I (7.67+ 2.12 days) with p<0.001. Mean scar length of Group I (5.466+2.9 cm) with respect to Group II (1.04+0.09) was significantly long (p<0.01). Rate of complications were not significantly different between two groups (p>0.5). Conclusion: For management of urinary bladder stones sized up to 4 cm, both open cystolithotomy and percutaneous cystolithotripsy are effective, with a low incidence of complications. However, comparing the surgery time, hospital stay, length of scar between two procedures, percutaneous cystolithotripsy procedure is more beneficial for treatment of urinary bladder stone.

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Which Criterion for Wound Drain Removal is Better Following Posterior 1-Level or 2-Level Lumbar Fusion With Instrumentation: Time Driven or Output Driven?

Global Spine Journal ◽

10.1177/21925682211013770 ◽

2021 ◽

pp. 219256822110137

Author(s):

Hang Shi ◽

Zhi-Hao Huang ◽

Yong Huang ◽

Lei Zhu ◽

Zan-Li Jiang ◽

...

Keyword(s):

Blood Loss ◽

Hospital Stay ◽

Lumbar Fusion ◽

Demographic Characteristics ◽

Total Blood ◽

Duration Of Hospital Stay ◽

Drain Removal ◽

Group I ◽

Wound Drain ◽

Group Ii

Study Design: Case-control study. Objectives: To compare the outcomes of 2 different criteria (time driven and output driven) for wound drain removal and identify which one is better. Methods: 743 patients who underwent posterior lumbar fusion with instrumentation involving 1 or 2 motion segments were enrolled in this study. Based on the different criteria for drain removal, the patients were divided into 2 groups. The drains were discontinued by time driven (postoperative day 2) in group I and output driven (<50 ml per day) in group II. Demographic characteristics, perioperative parameters and clinical outcomes were compared between the 2 groups. Results: The demographic characteristics in both groups were comparable. The postoperative drain output, total blood loss, postoperative timing of ambulation, and postoperative duration of hospital stay in group I were lower than those in group II ( P < 0.001). There was a higher proportion of patients requiring postoperative blood transfusion in group II, but not to a level of statistical significance ( P = 0.054). There was no statistical significant difference in the incidence of surgical site infection (SSI) or symptomatic spinal epidural hematoma (SEH) between the 2 groups ( P > 0.05). Conclusions: This study reveals that there are more benefits of wound drain removal by time driven than that by output driven for patients undergoing posterior 1-level or 2-level lumbar fusion with instrumentation, including less postoperative drain output, less total blood loss, earlier postoperative timing of ambulation and less postoperative duration of hospital stay without increasing the incidence of postoperative SSI or symptomatic SEH.

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The Effect of Smith-Peterson Osteotomy on Blood Loss during Surgical Correction of Adolescent Idiopathic Scoliosis

Folia Medica ◽

10.3897/folmed.62.e47790 ◽

2020 ◽

Vol 62 (3) ◽

pp. 503-508

Author(s):

Anastasia Ivanova ◽

Mikhail Mikhaylovskiy ◽

Vyacheslav Novikov ◽

Aleksandr Vasyura ◽

Vitaliy Lukinov ◽

...

Keyword(s):

Adolescent Idiopathic Scoliosis ◽

Blood Loss ◽

Idiopathic Scoliosis ◽

Surgical Correction ◽

Intraoperative Blood Loss ◽

Transpedicular Fixation ◽

Group I ◽

Significant Difference ◽

Group Ii ◽

Blood Loss Volume

Introduction: Surgical correction of adolescent idiopathic scoliosis is inevitably accompanied by blood loss. About 37–85% of patients undergo allogeneic transfusions associated with a risk of serious complications. Prediction of the expected blood loss volume remains a topical problem. In this regard, there is a need to clarify predictors of increased blood loss. Aim: To assess the effect of vertebrectomy on the intraoperative blood loss volume during surgical correction of adolescent idiopathic scoliosis. Materials and methods: A retrospective study included 511 adolescents who underwent posterior correction of spinal deformity. Two groups were allocated: Group I consisted of 303 patients who underwent multilevel transpedicular fixation; Group II included 208 patients who underwent multilevel transpedicular fixation combined with Smith-Peterson osteotomy. Results: Intergroup comparisons revealed significant differences in the number of transpedicular fixation levels and the volume of blood loss, which were higher in Group II. After aligning the groups by the number of transpedicular fixation levels using the Propensity Score Matching method, no statistically significant difference was observed. We derived formulas for calculating the expected blood loss volume in Groups I and II. Comparison of the formulas revealed that the formula for Group II predicted a significantly lower volume of blood loss, by 2.51%, while the formula for Group I predicted a significantly higher volume of blood loss, by 3.27%. In our opinion, application of the formula that overestimates expected intraoperative blood loss is most reasonable due to a possibility of the worst case scenario during surgery; therefore, the formula for Group I approaches a universal model for use. Conclusion: Smith-Peterson osteotomy did not affect the amount of blood loss during surgical correction of adolescent idiopathic scoliosis, considering the number of transpedicular fixation levels.

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Safety and feasibility of laparoendoscopic single-site surgery in the management of giant ovarian cysts

10.21203/rs.3.rs-895668/v1 ◽

2021 ◽

Author(s):

Shuzhen Chang ◽

Wei Zhang ◽

Linyv Peng ◽

Haiyan Zhou ◽

HAN Li-ping

Keyword(s):

Blood Loss ◽

Hospital Stay ◽

Perioperative Complications ◽

Operation Time ◽

Postoperative Hospital Stay ◽

Ovarian Cysts ◽

Intraoperative Blood Loss ◽

Analgesic Drugs ◽

Laparoendoscopic Single Site Surgery ◽

Single Site Surgery

Abstract Objective To investigate the safety and feasibility of laparoendoscopic single-site surgery (LESS) in the treatment of giant ovarian cysts. Methods A total of 76 patients with giant ovarian cyst (diameter ≥ 10 cm) who received surgical treatment in our hospital from January 2018 to May 2021 were divided into experimental cohort (single-port laparoscopic cohort) (n = 30) and control cohort (traditional laparoscopic cohort) (n = 46).The operation time, intraoperative blood loss, intraoperative cyst fluid spillage rate, application of postoperative analgesic drugs, postoperative first anus exhaust time, incidence rate of perioperative complications, length of postoperative hospital stay and other clinical indicators were summarized and analyzed between the two cohorts. Results The LESS cohorts had an earlier onset of age[ (27.6 ± 8.4) ,years of age], shorter of operation time [(82.2 ± 16.0)min], less of intraoperative blood loss [( 17.5 (10-22.5) ml)] as compared with traditional laparoscopic cohort[ (40.9 ± 15.5 )years of age, (102.7 ± 26.2)min, (20 (18.7–35) )m,P ༜ 0.05]. The first postoperative exhaust time,the rate of postoperative analgesic drugs, incidence rate of perioperative complications and postoperative hospital stay in two cohorts were in the similar line. Conclusion After adequate evaluation and screening of patients, the size of ovarian cysts cannot be the reason for refusing LESS surgery. It is safe and feasible for clinical promotion in the management of giant ovarian cysts.

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