目的：分析机器人辅助单孔腹腔镜（R-LESS）与机器人辅助多孔腹腔镜（R-LEMS ）在子宫肌瘤剔除 术中的应用疗效。方法：在 PubMed、Cochrane Library、Embase 数据库检索 2000 年 1 月—2023 年 7 月在 R-LESS 和 R-LEMS 下行子宫肌瘤剔除术的相关文献。对比两种术式围手术期资料，并进行 Meta 分析。结果：本研究共纳入 5 篇回顾性研究，总计869例患者的临床资料，其中376例患者行R-LESS子宫肌瘤剔除术（R-LESS组），493例行R-LEMS 子宫肌瘤剔除术（R-LEMS 组）。Meta 分析显示，与 R-LEMS 组相比，R-LESS 组在取瘤时间和术中失血量等方面显 著优于 R-LEMS 组（P<0.00001），但在手术对接时间方面，R-LESS 组所需时间更长（P=0.0006）。与 R-LEMS 组相比， R-LESS 组的总手术时间、住院时间、术中及术后并发症、控制台时间有所减少，但差异无统计学意义。结论：R-LESS 子宫肌瘤剔除术在取瘤时间和术中失血量方面显著优于 R-LEMS 子宫肌瘤剔除术，体现了单孔手术在遵循无瘤原则及 实现美容切口方面的优势，尽管对接时间略有增加，但总体手术效果和患者恢复情况仍显示出良好的安全性和可行性。

Objective: To analyze the clinical efficacy of robot-assisted laparoendoscopic single-site surgery (R-LESS) and robot-assisted laparoendoscopic multiple-site surgery (R-LEMS) for myomectomy. Methods: Relevant literatures on R-LESS and R-LEMS for myomectomy in the PubMed, Cochrane Library, and Embase databases from January 2000 to July 2023 were retrieved. Perioperative data for the two surgical approaches were compared and analyzed using Meta-analysis. Results: A total of 5 retrospective studies, comprising clinical data from 869 patients, were included. Among them, 376 patients underwent R-LESS for myomectomy, while 493 underwent R-LEMS for myomectomy. Meta-analysis results indicated that R-LESS was significantly better than R-LEMS in tumor removal time and intraoperative blood loss (P<0.00001). However, R-LESS took longer in terms of docking time (P=0.0006). Compared with the R-LEMS, the total operative time, length of hospital stay, intraoperative and postoperative complications, and console Controlling time were lower in the R-LESS group, but the differences were not statistically significant. Conclusion: The R-LESS for myomectomy demonstrates significant advantages over the R-LEMS in terms of tumor removal time and intraoperative blood loss, highlighting the benefits of single-site surgery in adhering to the no-tumor principle and cosmetic effect. Despite a slight increase in the docking time, the overall surgical outcomes and patient recovery indicate good safety and feasibility of R-LESS.

收稿日期：2023-06-12  录用日期：2023-11-24 

Received Date: 2023-06-12  Accepted Date: 2023-11-24 

基金项目：辽宁省重点研发项目（2024JH2/102500019）；2022 年沈阳市科技计划项目（22-321-33-08）；沈阳市科技局 2023 年助力中国医科大学高质量发展专项（23-506-3-01-10） 

Foundation Item: Key R & D Project of Liaoning Province(2024JH2/102500019); Science and Technology Plan Project of Shenyang in 2022(22-321-33-08); Special Project to Support High-quality Development of Chines Medical Universities of Shenyang Bureau of Science and Technology in 2023 (23-506-3-01-10) 

通讯作者：张颐，Email：syzi@163.com 

Corresponding Author: ZHANG Yi, Email: syzi@163.com 

引用格式：王煜宁，庞晓燕，王亚静，等 . 机器人辅助单孔腹腔镜子宫肌瘤剔除术 Vs 机器人辅助多孔腹腔镜子宫肌瘤剔除术：系 统评价与 Meta 分析 [J]. 机器人外科学杂志（中英文），2024，5（6）：1197-1204. 

Citation: WANG Y N, PANG X Y, WANG Y J, et al. Robot-assisted laparoendoscopic single-site Vs multi-site surgery for myomectomy: a systematic review and Meta-analysis [J]. Chinese Journal of Robotic Surgery, 2024, 5(6): 1197-1204.

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