Comparison of effects of robotic surgery,laparoscopy surgery and laparotomy in treatment of ovarian cancer

Objective To study the effects of comprehensive staging operation via robotic laparoscopic surgery or laparotomy on patients with ovarian cancer. Methods From January 1,2013 to December 31,2018,160 patients with ovarian cancer underwent comprehensive staging operations in our hospital.According to the operation methods,the patients were divided into three groups,including laparotomy group (n=75),laparoscopy group (n=52) and robotic group (n=33).The perioperative parameters including operating time,intraoperative blood loss,intraoperative blood transfusion rate,number of lymph nodes resected,intraoperative complications and postoperative fever and other postoperative indicators such as exhaust time and pathological types,and the recurrence data from postoperation to July 31st,2019 were compared between the three groups. Results There was no significant difference in age,BMI,medical complications and abdominal surgery history between the three groups.No significant difference was found in operating time between the three groups (P=0.111).The intraoperative blood loss in the robotic group and the laparoscopy group was significantly lower than that in the laparotomy group (179.55±145.75) ml and (229.71±162.49) ml vs (350.76±239.95) ml,P=0.000.The intraoperative blood transfusion rate in the robotic group and the laparoscopy group was significantly less than that in the laparotomy group (18.19% and 19.23% vs 42.67%,P=0.000).The number of lymph nodes resected in the robotic group was higher than that in the laparoscopy group and the laparotomy group (30.28±11.20) vs (27.97±12.96) and (22.33±8.22),P=0.004.There was no statistically significant difference in intraoperative complications,postoperative fever and other postoperative indicators between the three groups (all P>0.05).The postoperative exhaust time in the laparoscopy group and the robotic group was earlier than that of the laparotomy group (1.88±1.19) d and (2.38±1.13) d vs (2.70±0.96) d,P=0.000.The follow-up was lasted to July 31,2019,and there was no significant difference in progress free survival between the three groups (P=0.185). Conclusion Robotic surgery and laparoscopic surgery in comprehensive staging operation are safe and effective in selected patients with ovarian cancer.