肿瘤特异性直肠系膜切除（TSME）仅依赖于小规模的回顾性研究来治疗直肠癌。本研究旨在进行系统综述和荟萃分析，以评估TSME治疗的肿瘤学和功能学结果。绘制了系统综述方案，包括所有比较针对直肠腺癌的部分切除与全系膜切除（PME vs TME）的研究，距离肛缘16厘米以内。在EMBASE-Medline、Pubmed和Cochrane Library上进行了系统文献检索。对研究结果进行筛选：肿瘤学根治性、术后吻合口漏风险和功能学结果。对纳入的研究进行偏倚风险评估并进行荟萃分析。根据GRADE方法评估证据等级。 纳入了27项研究，共12325例患者（PME n = 4460，36.2％；TME n = 7865，63.8％）。54.5％的患者中，将PME用于距离肛缘10厘米以上的肿瘤。PME与TME在环周切缘阳性率（OR 1.31，95％CI 0.43-3.95，p = 0.64；I2 = 38％）和局部复发风险（HR 1.05，95％CI 0.52-2.10，p = 0.90；I2 = 40％）方面无差异。PME手术后的吻合口漏风险（OR 0.42，95％CI 0.27-0.67，p < 0.001；I2 = 60％）和主要低位前切除综合征风险（OR 0.34，95％CI 0.28-0.40，p < 0.001；I2 = 0％）较低。尿失禁（OR 0.68，95％CI 0.13-3.67，p = 0.66）和早期导尿管拆除后的尿潴留（OR 2.00，95％CI 0.24-16.51，p = 0.52）方面没有差异。这个荟萃分析的证据表明，TSME治疗直肠癌具有良好的肿瘤学效果，并为患者的情况带来了最适合的功能学结果。© 2023 Published by Elsevier Ltd.

Tumour-specific mesorectal excision (TSME) practice for rectal cancer only relies on small retrospective studies. This study aimed to perform a systematic review and meta-analysis to assess the oncological and functional outcomes of TSME practice.A systematic review protocol was drawn to include all the studies that compared partial versus total mesorectal excision (PME vs TME) practised for rectal adenocarcinoma up to 16 cm from the anal verge. A systematic literature search was conducted on EMBASE-Medline, Pubmed and Cochrane Library. Reports were screened for the study's outcomes: oncological radicality, postoperative anastomotic leak risk and functional outcomes. Included studies were appraised for risk-of-bias and meta-analysed. Evidence was rated with the GRADE approach.Twenty-seven studies were included, consisting of 12325 patients (PME n = 4460, 36.2%; TME n = 7865, 63.8%). PME was performed for tumours higher than 10 cm from the anal verge in 54.5% of patients. There was no difference between PME and TME in circumferential resection margin positivity (OR 1.31, 95%CI 0.43-3.95, p = 0.64; I2 = 38%), and local recurrence risk (HR 1.05, 95%CI 0.52-2.10, p = 0.90; I2 = 40%). The postoperative leak risk (OR 0.42, 95%CI 0.27-0.67, p < 0.001; I2 = 60%) and the major low anterior resection syndrome risk (OR 0.34, 95%CI 0.28-0.40, p < 0.001; I2 = 0%) were lower after PME surgery. No difference was found in urinary incontinence (OR 0.68, 95%CI 0.13-3.67, p = 0.66) and urinary retention after early catheter removal (OR 2.00, 95%CI 0.24-16.51, p = 0.52).Evidence from this meta-analysis shows that TSME for rectal cancer has good oncological results and leads to the best-fitted functional results possible for the patient's condition.© 2023 Published by Elsevier Ltd.