To compare the efficacy of robotic, laparoscopic surgery and laparotomy in the treatment of primary cytoreductive surgery for FIGO stage Ⅱ-Ⅲ ovarian cancer.

A total of 130 patients who received primary cytoreductive surgery for ovarian cancer in Department of Gynecology and Obstetrics, The First Medical Center of Chinese PLA General Hospital from Jan. 2016 to Dec. 2020 were collected. According to different surgical methods, they were divided into three groups, including laparotomy group (n= 87), laparoscopy group (n= 23) and robotic group (n= 20). Perioperative parameters (operation time, intraoperative blood loss, intraoperative blood transfusion rate, total number of dissected lymph nodes, intraoperative complications, postoperative fever and other postoperative complications, postoperative exhaust time, postoperative pathological types) were compared among the three groups, as well as disease recurrence during postoperative follow-up until Dec. 2021.

There was no significant difference in age, BMI, medical complications and previous abdominal surgery among the three groups (P> 0.05). No significant difference was found in operating time among the three groups (P= 0.328); The intraoperative blood loss in robotic group and laparoscopic group was significantly lower than that in the laparotomy group [(231.00 ± 320.20)ml and (241.30 ± 118.37)ml vs (823.68 ± 685.73)ml] (P<0.001); and the intraoperative blood transfusion rate in robotic group and laparoscopic group was significantly less than that in laparotomy group (5.00% and 0.00% vs 48.28%, P< 0.001); There was no significant differencein the total number of dissected lymph nodes, postoperative fever and postoperative complications among the three groups (P>0.05); The intraoperative complication rate in robotic group and laparoscopic group was significantly lower than that in laparotomy group (5.00% and 0.00% vs 17.24%, P= 0.046); And the postoperative exhaust time in robotic group and laparoscopic group was earlier than that in laparotomy group [(2.15 ± 0.81) d and (1.87 ± 0.97) d vs (3.06 ± 1.09) d](P< 0.001). The follow-up was lasted to Dec. 2021, and there was no significant difference in postoperative progression-free survival among the three groups (P= 0.601).

Robotic and laparoscopic surgery in primary cytoreductive surgery are safe and reliable for selected patients with FIGO stage Ⅱ-Ⅲ ovarian cancer.