Pulmonary embolism after shoulder surgery:Is it a real threat?

Pulmonary embolism(PE)is a rare but devastating complication of shoulder surgery.Apart from increased morbidity and mortality rates,it may significantly impair postoperative recovery and functional outcome.Its frequency accounts for up to 5.7%of all shoulder surgery procedures with a higher occurrence in women and patients older than 70 years.It is most commonly associated with thrombophilia,diabetes mellitus,obesity,smoking,hypertension,and a history of malignancy.PE usually occurs secondary to upper or lower-extremity deep vein thrombosis(DVT).However,in rare cases,the source of the thrombi cannot be determined.Prophylaxis for PE following shoulder surgery remains a topic of debate,and the standard of care does not routinely require prophylactic medication for DVT prophylaxis.Early ambulation and elastic stockings are important preventative measures for DVT of the lower extremity and medical agents such as aspirin,low-molecular-weight heparin,and vitamin K antagonists are indicated for high-risk patients,long-lasting operations,or concomitant severe acute respiratory syndrome coronavirus 2 infection.The most common symptoms of PE include chest pain and shortness of breath,but PE can also be asymptomatic in patients with intrinsic tolerance of hypoxia.Patients with DVT may also present with swelling and pain of the respective extremity.The treatment of PE includes inpatient or outpatient anticoagulant therapy if the patient is hemodynamically unstable or stable,respectively.Hemodynamic instability may require transfer to the intensive care unit,and cardiovascular arrest can be implicated in fatal events.An important issue for patients with PE in the postoperative period after shoulder surgery is residual stiffness due to a delay in rehabilitation and a prolonged hospital stay.Early physiotherapy and range-of-motion exercises do not adversely affect the prognosis of PE and are highly recommended to preserve shoulder mobility and function.

Survival analysis following early surgical success in intermittent exotropia surgery

AIM:To assess the consecutive recurrence following early success of intermittent exotropia surgery and to determine the clinical factors that affect the survival.METHODS:One hundred and thirty-five patients who underwent intermittent exotropia surgery and experienced early surgical success[≤5 prism diopters(PD)esophoria(E)to≤10 PD exophoria(X)on the postoperative sixth month]were enrolled in this study.Their consecutive survival on the postoperative first year,second year and third year and at the last visit of fourth year or more,and the factors that might affect their survival,were analyzed.The final surgical outcomes after the postoperative fourth year were also investigated by dividing the patients into the success group(≤5 PD E to≤10 PD X)and the failure group(】5 PD esodeviation or】10 PD exodeviation)RESULTS:The survival rates from the Kaplan-Meier analysis were 97.78%,92.89%,83.70%and 50.49%on the postoperative first,second and third years and fourth year or more,respectively.None of the clinical factors was determined to have affected the survival.The amount of the exodrift was largest(2.29 PD)between the first year and the second year,and smallest(1.47 PD)between the fourth year and the last visit.Sixty-three patients had their final visit after the postoperative fourth year,and 29 of them were in the failure group.Twentyfive patients in the failure group had an intermittent exotropia(IXT)of【20 PD with good to fair distant fusion;two had an IXT of【20 PD with poor distant fusion;one had an IXT of≥20 PD with fair distant fusion;and another had delayed-onset consecutive esotropia.The exodeviation on the postoperative sixth month was smaller in the success group than in the failure group(2.81 PD vs 5.86 PD,P=0.012).The reoperation rate for recurrent IXT was 3.7%.CONCLUSION:The survival rate steadily decreases with the exodrift,but the amount of the exodrift decreases with long-term follow-up.The final outcomes demonstrate favorable results via surgical success or small-angle IXT with good fusion in most of the patients.A smaller deviation on the postoperative sixth month is associated with long-term survival.

Clinical investigation of surgery for intermittent exotropia

Objective： To investigate the time and postoperative binocular vision of strabismus surgery for children with intermittent exotropia （X（T））. Methods： A retrospective investigation was conducted in 80 child patients with intermittent exotropia. Pre- and postoperative angles of deviation fixating at near （33 cm） and distant targets （6 m） were measured with the prolonged alternate cover testing. The binocular function was assessed with synoptophore. Twenty-one patients took the postoperative synoptophore exercise. Results： （1） A week after surgery, 96.2% of the 80 patients had binocular normotopia, while a year after surgery, 91.3% of the 80 patients had binocular normotopia; （2） Preoperatively, 58 patients had near stereoacuity, while postoperatively, 72 patients achieved near stereoacuity （P〈0.05）; （3） Preoperatively, 64 patients had Grade Ⅰ for the synoptophore evaluation and postoperatively, 76 patients achieved Grade Ⅰ. Meanwhile, 55 patients had Grade Ⅱ preoperatively and 72 achieved Grade Ⅱ postoperatively. For Grade Ⅲ, there were 49 patients preoperatively and 64 patients postoperatively （P〈0.05）; （4） Patients of 5-8 years old had a significantly better recovery rate of binocular vision than those of 9-18 years old （P〈0.05）; （5） Patients taking postoperative synoptophore exercise had a better binocular vision than those taking no exercise （P〈0.05）. Conclusions： （1） Strabismus surgery can help to preserve or restore the binocular vision for intermittent exotropia; （2） Receiving the surgery at young ages may develop better postoperative binocular vision; （3） The postoperative synoptophore exercise can help to restore the binocular vision.

Surgery at early versus late for intermittent exotropia:a Meta-analysis and systematic review

AIM:To compare the outcomes between early surgery and late surgery for intermittent exotropia(IXT)with a Metaanalysis.METHODS:Scientific databases including PubMed,Embase,Web of Science,Cochrane and China National Knowledge Infrastructure were searched prior to December 16,2019.From this broad database search,we performed some Meta-analysis including eleven independent studies,to further evaluate the outcome(s)when comparing early versus late surgery for IXT.The boundaries between early and late surgery and the surgery methods were not inconsistent,so subgroup analyses were conducted by different boundaries of age at surgery and different surgical approaches.The pooled odds ratios(ORs)and the 95%confidence interval(CI)were estimated according to the random-effects model for high heterogeneity between studies.RESULTS:Eleven retrospective studies were included in this Meta-analysis.No significant difference between early and late surgery was observed for IXT patients(OR_(First follow-up)=0.88,95%CI 0.53-1.44,P=0.61;OR_(Final follow-up)=1.48,95%CI 0.94-2.31,P=0.09).However,sensitivity analysis performed by sequentially omitting individual studies showed that the final follow-up result was not stable.Subgroup analyses revealed that an earlier surgical procedure could lead to a better outcome in the 4-year boundary subgroup as well as the bilateral lateral rectus recession(BLR)subgroup for the final follow-up(OR_(4y)=2.64,95%CI 1.57-4.44,P=0.00;OR_(BLR)=2.25,95%CI 1.36-3.74,P=0.00).CONCLUSION:Early surgery for IXT provides a better long term follow-up outcome when patients are younger than 4 years old or choose the BLR surgical method.

Factors affecting residual exotropia after two muscle surgery for intermittent exotropia

AIM： To study the factors affecting residual exotropia（〉10 PD） at 4-6wk postoperative visit following two rectus muscle surgery for intermittent exotropia [bilateral lateral rectus（LR） recession or unilateral recess resect procedure].METHODS： A retrospective chart review of patients with intermittent exotropia ≤50 PD who underwent two rectus muscle surgery in between Jan. 2011 to Dec. 2013 was performed. Possible factors were compared between patients with residual exotropia（〉10 PD） and successful outcome（within 10 PD of orthotropia） at the 4-6wk postoperative visit. Effect/dose ratio was calculated by dividing the effect of surgery by the total amount（mm） of muscle surgery done.RESULTS： One hundred and fifty-seven patients with mean age of 14y（range 3-53y） were included. Twentyseven patients（17.2%） had residual exotropia at 4-6wk postoperative follow up. Age at surgery（P=0.009） and preoperative deviation for distance（P≤0.001） and near（P=0.001） were identified as important predictors of unsuccessful outcome. The occurrence of residual exotropia was not affected by amblyopia, anisometropia, lateral incomitance, pattern deviation, vertical deviation, type of exotropia or type of surgery done（recess-resect or bilateral LR recession）. The effect/dose ratio was more in deviations 〉40 PD in the both recess-resect and bilateral LR recession type of surgery. The effect/dose ratio was less in patients with residual exotropia as compared to the successful outcome group（1.36 PD/mm vs 2.05 PD/mm in the bilateral LR recession surgery and 1.93 PD/mm vs 2.63 PD/mm in the unilateral recess-resect surgery）.CONCLUSION： Residual exotropia is seen in 17% of patients after two muscle surgery for intermittent exotropia. Patients with older age and larger preoperative deviation have greater chances of developing failure of two muscle strabismus surgery for intermittent exotropia.

New direction for surgery:Super minimally invasive surgery

The top goal of modern medicine is treating disease without destroying organ structures and making patients as healthy as they were before their sickness.Minimally invasive surgery(MIS)has dominated the surgical realm because of its lesser invasiveness.However,changes in anatomical structures of the body and reconstruction of internal organs or different organs are common after traditional surgery or MIS,decreasing the quality of life of patients post-operation.Thus,I propose a new treatment mode,super MIS(SMIS),which is defined as“curing a disease or lesion which used to be treated by MIS while preserving the integrity of the organs”.In this study,I describe the origin,definition,operative channels,advantages,and future perspectives of SMIS.

Botulinum toxin augmented bilateral lateral rectus recession versus three muscles surgery in large-angle intermittent exotropia

AIM: To report the surgical outcomes of correcting large angle intermittent exotropia in adult patients by bilateral lateral rectus muscle recession with intraoperative use of botulinum toxin and to compare the results with those of bilateral lateral rectus muscle recession and unilateral medial rectus resection. METHODS: The medical records of patients who underwent surgical correction of large angle intermittent exotropia [exotropia >50 prism dioptre(PD)] were retrospectively reviewed. Two groups of patients were identified;Group Ⅰ(21 patients) had bilateral lateral recti recession augmented with intraoperative botulinum toxin A(BTA) injection into the recessed muscles and group Ⅱ(30 patients) were treated by bilateral lateral recti recession with unilateral medial rectus muscle resection. Preoperative data were extracted for age, gender, refraction, type of exotropia, angle of stereopsis and angle of deviation. The main outcome measures were the postoperative angle of deviation and stereoacuity angle by Titmus test measured at the end of one year of postoperative follow up. RESULTS: By the end of the first postoperative year, 10 patients in group Ⅰ(47.6%) and 20 patients in group Ⅱ(66.7%) achieved esotropia/esophoria <5 PD or exotropia/exophoria <10 PD. The difference in surgical success rate was not statistically significant(P=0.1) but there was a statistically significant higher rate of undercorrection in group Ⅰ(P=0.03). On the other hand, 3 patients in group Ⅰ(14.3%) and 5 patients in group Ⅱ(16.7%) had improved stereopsis;this difference in the sensory outcome was not statistically significant(P=0.8). In the BTA augmented surgery group, good stereoacuity and smaller preoperative angle of deviation were associated with significantly higher surgical success rate(P=0.004, 0.01 respectively). CONCLUSION: BTA augmented bilateral lateral recti recession is associated with higher rate of undercorrection as compared to bilateral lateral recti recession with unilateral medial rectus resection in the correction of large angle intermittent exotropia. The surgical success rate in BTA augmented surgery group is observed to be higher in patients with preoperative smaller angle of deviation and in patients with good stereoacuity.

Bariatric surgery and diabetes:Current challenges and perspectives

Diabetes mellitus(DM)and obesity have become public issues of global concern.Bariatric surgery for the treatment of obesity combined with type 2 DM has been shown to be a safe and effective approach;however,there are limited studies that have systematically addressed the challenges of surgical treatment of obesity combined with DM.In this review,we summarize and answer the most pressing questions in the field of surgical treatment of obesity-associated DM.I believe that our insights will be of great help to clinicians in their daily practice.

Advances in surgery procedures for convergence insufficiency-type intermittent exotropia

Intermittent exotropia with convergence insufficiency is defined as a greater exodeviation measured at near than at distance of at least 10 prism diopters and it is harmful to binocular vision at earlier time. This paper mainly introduces three operation patterns including lateral rectus recession(s) with or without a slanting procedure, unilateral lateral rectus recession with medial rectus resection, and medial rectus resection(s) with or without a slanting procedure.

Consecutive Exotropia after Convergent Strabismus Surgery—Surgical Treatment

Purpose: In this study the results of consecutive exotropia surgical treatment by using different surgical technics are presented. Methods: This study included 34 patients, aged 21 to 47 years (mean 27.9), who underwent medial rectus muscle advancement alone or in combination with medial rectus resection and/or lateral rectus recession. The mean interval between original surgery and surgery for consecutive exotropia was 8.5 years (range: 5.5 years to 14 years). Most of patients had 2 and more prior surgeries (73.5%) sold by an adduction deficit (47.06%). Results: The overall mean preoperative exodeviation was 35.12 ± 10.13 PD. Satisfactory alignment (within 10 PD of orthophoria) was achieved in 20 patients (58.8%) at 10 days after surgery and 24 patients (70.5%) at final 6-month follow-up. The most common surgical procedures were unilateral MR advancement and LR recession—47%. Conclusion: Medial rectus advancement is an effective method of surgical treatment, especially in cases with adduction limitation, but the risk of the eyelid fissure narrowing in cases of MRM advancement more than 5 mm associated with resection is present. In our opinion for reducing this risk in cases of XT with big angle of deviation, performing a smaller amount of advancement associated with recession of LRM can prevent the development of a such complication.

Artificial Intelligence and Computer Vision during Surgery: Discussing Laparoscopic Images with ChatGPT4—Preliminary Results

Introduction: Ultrafast latest developments in artificial intelligence (ΑΙ) have recently multiplied concerns regarding the future of robotic autonomy in surgery. However, the literature on the topic is still scarce. Aim: To test a novel AI commercially available tool for image analysis on a series of laparoscopic scenes. Methods: The research tools included OPENAI CHATGPT 4.0 with its corresponding image recognition plugin which was fed with a list of 100 laparoscopic selected snapshots from common surgical procedures. In order to score reliability of received responses from image-recognition bot, two corresponding scales were developed ranging from 0 - 5. The set of images was divided into two groups: unlabeled (Group A) and labeled (Group B), and according to the type of surgical procedure or image resolution. Results: AI was able to recognize correctly the context of surgical-related images in 97% of its reports. For the labeled surgical pictures, the image-processing bot scored 3.95/5 (79%), whilst for the unlabeled, it scored 2.905/5 (58.1%). Phases of the procedure were commented in detail, after all successful interpretations. With rates 4 - 5/5, the chatbot was able to talk in detail about the indications, contraindications, stages, instrumentation, complications and outcome rates of the operation discussed. Conclusion: Interaction between surgeon and chatbot appears to be an interesting frontend for further research by clinicians in parallel with evolution of its complex underlying infrastructure. In this early phase of using artificial intelligence for image recognition in surgery, no safe conclusions can be drawn by small cohorts with commercially available software. Further development of medically-oriented AI software and clinical world awareness are expected to bring fruitful information on the topic in the years to come.

Fully automatic AI segmentation of oral surgery-related tissues based on cone beam computed tomography images

Accurate segmentation of oral surgery-related tissues from cone beam computed tomography(CBCT)images can significantly accelerate treatment planning and improve surgical accuracy.In this paper,we propose a fully automated tissue segmentation system for dental implant surgery.Specifically,we propose an image preprocessing method based on data distribution histograms,which can adaptively process CBCT images with different parameters.Based on this,we use the bone segmentation network to obtain the segmentation results of alveolar bone,teeth,and maxillary sinus.We use the tooth and mandibular regions as the ROI regions of tooth segmentation and mandibular nerve tube segmentation to achieve the corresponding tasks.The tooth segmentation results can obtain the order information of the dentition.The corresponding experimental results show that our method can achieve higher segmentation accuracy and efficiency compared to existing methods.Its average Dice scores on the tooth,alveolar bone,maxillary sinus,and mandibular canal segmentation tasks were 96.5%,95.4%,93.6%,and 94.8%,respectively.These results demonstrate that it can accelerate the development of digital dentistry.

Is recovery enhancement after gastric cancer surgery really a safe approach for elderly patients?

BACKGROUND This study aimed to evaluate the safety of enhanced recovery after surgery(ERAS)in elderly patients with gastric cancer(GC).AIM To evaluate the safety of ERAS in elderly patients with GC.METHODS The PubMed,EMBASE,and Cochrane Library databases were used to search for eligible studies from inception to April 1,2023.The mean difference(MD),odds ratio(OR)and 95%confidence interval(95%CI)were pooled for analysis.The quality of the included studies was evaluated using the Newcastle-Ottawa Scale scores.We used Stata(V.16.0)software for data analysis.RESULTS This study consists of six studies involving 878 elderly patients.By analyzing the clinical outcomes,we found that the ERAS group had shorter postoperative hospital stays(MD=-0.51,I2=0.00%,95%CI=-0.72 to-0.30,P=0.00);earlier times to first flatus(defecation;MD=-0.30,I²=0.00%,95%CI=-0.55 to-0.06,P=0.02);less intestinal obstruction(OR=3.24,I2=0.00%,95%CI=1.07 to 9.78,P=0.04);less nausea and vomiting(OR=4.07,I2=0.00%,95%CI=1.29 to 12.84,P=0.02);and less gastric retention(OR=5.69,I2=2.46%,95%CI=2.00 to 16.20,P=0.00).Our results showed that the conventional group had a greater mortality rate than the ERAS group(OR=0.24,I2=0.00%,95%CI=0.07 to 0.84,P=0.03).However,there was no statistically significant difference in major complications between the ERAS group and the conventional group(OR=0.67,I2=0.00%,95%CI=0.38 to 1.18,P=0.16).CONCLUSION Compared to those with conventional recovery,elderly GC patients who received the ERAS protocol after surgery had a lower risk of mortality.

Enhanced recovery after surgery in elderly patients with non-small cell lung cancer who underwent video-assisted thoracic surgery

BACKGROUND This study was designed to investigate the clinical outcomes of enhanced recovery after surgery(ERAS)in the perioperative period in elderly patients with nonsmall cell lung cancer(NSCLC).AIM To investigate the potential enhancement of video-assisted thoracic surgery(VATS)in postoperative recovery in elderly patients with NSCLC.METHODS We retrospectively analysed the clinical data of 85 elderly NSCLC patients who underwent ERAS(the ERAS group)and 327 elderly NSCLC patients who received routine care(the control group)after VATS at the Department of Thoracic Surgery of Peking University Shenzhen Hospital between May 2015 and April 2017.After propensity score matching of baseline data,we analysed the postoperative stay,total hospital expenses,postoperative 48-h pain score,and postoperative complication rate for the 2 groups of patients who underwent lobectomy or sublobar resection.RESULTS After propensity score matching,ERAS significantly reduced the postoperative hospital stay(6.96±4.16 vs 8.48±4.18 d,P=0.001)and total hospital expenses(48875.27±18437.5 vs 55497.64±21168.63 CNY,P=0.014)and improved the satisfaction score(79.8±7.55 vs 77.35±7.72,P=0.029)relative to those for routine care.No significant between-group difference was observed in postoperative 48-h pain score(4.68±1.69 vs 5.28±2.1,P=0.090)or postoperative complication rate(21.2%vs 27.1%,P=0.371).Subgroup analysis showed that ERAS significantly reduced the postoperative hospital stay and total hospital expenses and increased the satisfaction score of patients who underwent lobectomy but not of patients who underwent sublobar resection.CONCLUSION ERAS effectively reduced the postoperative hospital stay and total hospital expenses and improved the satisfaction score in the perioperative period for elderly NSCLC patients who underwent lobectomy but not for patients who underwent sublobar resection.

Uterine artery pseudoaneurysm caused by hysteroscopic surgery: A case report

BACKGROUND We report a case of uterine artery pseudoaneurysm(UAP)occurrence during hysteroscopic endometrial polypectomy and its treatment via uterine artery embolization(UAE).CASE SUMMARY A 48-year-old primigravid,primiparous patient was incidentally found to have an endometrial polyp during a health checkup,and underwent a hysteroscopic polypectomy at another hospital.Her cervix was dilated with a Laminken-R®device.After the Laminken-R®was withdrawn,a large amount of genital bleeding was observed.This bleeding persisted after the hysteroscopic polypectomy,and,as hemostasis became impossible,the patient was transferred to our hospital by ambulance.On arrival,transvaginal ultrasonography revealed a 3-cm hypoechoic mass with a swirling internal pulse on the right side of the uterus,and color Doppler ultrasonography showed feeder vessels penetrating the mass.Pelvic contrast-enhanced computed tomography(CT)confirmed the presence of a mass at this site,and vascular proliferation was observed within the uterine cavity.Consequently,UAP was diagnosed,and UAE was performed.The patient’s postoperative course was uneventful,and 6 mo post-UAE,no recurrence of blood flow to the UAP was observed.CONCLUSION When abnormal genital bleeding occurs during hysteroscopic surgery,ultrasonography and contrast-enhanced CT can assist in the detection of early UAPs.

Glaucoma surgery experiments using digital microscope-integrated optical coherence tomography and OCT-compatible instruments

There is a certain failure rate in traditional glaucoma surgery because of the lack of depth information in microscope images.In this work,we present a digital microscope-integrated optical coherence tomography(MIOCT)system and several custom-made OCT-compatible instruments for glaucoma surgery.Sixteen ophthalmologists were asked to perform trabeculectomy and canaloplasty on live porcine eyes using the system and instruments.After surgery,a subjective feedback survey about the user experience was taken.The experiment results showed that our system can help surgeons easily locate important tissue structures during surgery.The custom-made instruments also solved the shadowing problem in OCT imaging.Surgeons preferred to use the system in their future practice.

Effect of bariatric surgery on metabolism in diabetes and obesity comorbidity:Insight from recent research

Obesity is a prevalent cause of diabetes mellitus(DM)and is a serious danger to human health.Type 2 DM(T2DM)mostly occurs along with obesity.Foodborne obesity-induced DM is caused by an excessive long-term diet and surplus energy.Bariatric surgery can improve the symptoms of T2DM in some obese patients.But different types of bariatric surgery may have different effects.There are some models built by researchers to discuss the surgical procedures’effects on me-tabolism in diabetes animal models and diabetes patients.It is high time to conclude all this effects and recommend procedures that can better improve metabolism.

Treatment of hemolymphangioma by robotic surgery: A case report

BACKGROUND Hemolymphangioma of the jejunum is rare and lacks clinical specificity,and can manifest as gastrointestinal bleeding,abdominal pain,and intestinal obstruction.Computed tomography,magnetic resonance imaging,and other examinations show certain characteristics of the disease,but lack accuracy.Although capsule endoscopy and enteroscopy make up for this deficiency,the diagnosis also still re-quires pathology.CASE SUMMARY A male patient was admitted to the hospital due to abdominal distension and abdominal pain,but a specific diagnosis by computed tomography examination was not obtained.Partial resection of the small intestine was performed by robotic surgery,and postoperative pathological biopsy confirmed the diagnosis of hemo-lymphangioma.No recurrence in the follow-up examination was observed.CONCLUSION Robotic surgery is an effective way to treat hemolymphangioma through minima-lly invasive techniques under the concept of rapid rehabilitation.

Obesity: Body Relief Surgeries before Bariatric Surgery for Risk Reduction

Depending on the treatment and weight of the breasts or abdomen, they may exceed volumes considered giant and morbidly obese. In these cases, and when the patient’s BMI is high above 40 kg/m2, the weight of the breasts or abdomen produces what we consider suffocation when the patient is placed in horizontal position on surgical tables, decreasing his respiratory capacity and increasing the difficulty in treating respiratory or embolic risks. An 8-kg breast on the patient’s chest prevents normal breathing. An abdomen with a volume of 30 kg causes difficulties in all senses, making the physiological expansion of the lungs impossible and even preventing surgical assistance to patients. These patients are almost always customers who sleep in the sitting position to breathe better. The gigantic extirpation of the surgical parts facilitates a better respiratory expansion reducing by a large percentage the risk of death, what we call body relief. This relief does not free the patient from bariatric surgery for a possible weight loss, which is vital for the proper functioning of the organs and decreasing arterial hypertension and diabetes.

Efficacy and safety of minimally invasive laparoscopic surgery under general anesthesia for ovarian cancer

BACKGROUND Ovarian cancer is one of the most common malignant tumors in female reproductive system in the world,and the choice of its treatment is very important for the survival rate and prognosis of patients.Traditional open surgery is the main treatment for ovarian cancer,but it has the disadvantages of big trauma and slow recovery.With the continuous development of minimally invasive technology,minimally invasive laparoscopic surgery under general anesthesia has been gradually applied to the treatment of ovarian cancer because of its advantages of less trauma and quick recovery.However,the efficacy and safety of minimally invasive laparoscopic surgery under general anesthesia in the treatment of ovarian cancer are still controversial.AIM To explore the efficacy and safety of general anesthesia minimally invasive surgery in the treatment of ovarian cancer.METHODS The clinical data of 90 patients with early ovarian cancer in our hospital were analyzed retrospectively.According to the different surgical treatment methods,patients were divided into study group and control group(45 cases in each group).The study group received minimally invasive laparoscopic surgery under general anesthesia for ovarian cancer,while the control group received traditional open surgery for ovarian cancer.The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire(EORTC QLQ-C30),clinical efficacy and safety of the two groups were compared.RESULTS The intraoperative blood loss,length of hospital stay,postoperative gas evacuation time,and postoperative EORTC QLQ-C30 score of the study group were significantly better than those of the control group(P<0.05).The incidence of postoperative complications in the study group was significantly lower than in the control group(P<0.05).The two groups had no significant differences in the preoperative adrenocorticotropic hormone(ACTH),androstenedione(AD),cortisol(Cor),cluster of differentiation 3 positive(CD3+),and cluster of differentiation 4 positive(CD4+)indexes(P>0.05).In contrast,postoperatively,the study group's ACTH,AD,and Cor indexes were lower,and the CD3+and CD4+indexes were higher than those in the control group(P<0.05).CONCLUSION Minimally invasive laparoscopic surgery under general anesthesia in patients with early ovarian cancer can significantly improve the efficacy and safety,improve the short-term prognosis and quality of life of patients,and is worth popularizing.