对低位直肠癌患者进行机器人低位前切除术 (rTME) 和经肛门全直肠系膜切除术 (TaTME) 的比较结果进行了评估。使用以下数据库进行了系统的在线搜索：PubMed、Scopus、Cochrane 数据库、The Virtual Health图书馆、Clinical Trials.gov 和 Science Direct。纳入了 rTME 与 TaTME 治疗低位直肠癌的比较研究。主要结局是术后并发症，包括吻合口瘘、手术部位感染和 Clavien-Dindo 并发症发生率。总手术时间、转为开放手术、术中失血量、强化治疗室 (ITU) 和总住院时间 (LOS)、肿瘤学结果和功能结果是其他评估的结果参数。共有 12 项研究，总共 3025 名患者分为 rTME (n = 1881) 和 TaTME (n = 1144) 组。两组总手术时间（P = 0.39）、中转开放手术（P = 0.29）和术中失血量（P = 0.62）差异无统计学意义。 Clavien-Dindo ≥ 3 并发症发生率 (P = 0.47)、吻合口瘘 (P = 0.89)、再次手术率 (P = 0.62) 和再次入院率 (P = 0.92)、R0 切除率 (P = 0.52)，ITU两组之间的 LOS (P = 0.63) 和总医院 LOS (P = 0.30) 也显示出相似的结果。然而，rTME 组的淋巴结总切除率 (P = 0.04) 和完全直肠系膜切除 (TME) 切除率 (P = 0.05) 较高。尽管数据集有限，但与 TaTME 组相比，rTME 组的 Wexner 评分和低位前切除综合征 (LARS) 评分显示出更好的功能结果（分别为 P = 0.0009 和 P = 0.00001）。与 TaTME 相比，rTME 似乎提供了更好的功能结果、更高的淋巴结产量和更完整的 TME 切除，且术后并发症相似。© 2024。Springer Nature Switzerland AG。

Comparative outcomes of robotic low anterior resection (rTME) and trans-anal total mesorectal excision (TaTME) in patients with low rectal cancer were evaluated.A systematic online search was conducted using the following databases: PubMed, Scopus, Cochrane database, The Virtual Health Library, Clinical trials.gov and Science Direct. Comparative studies of rTME versus TaTME for low rectal cancer were included. Primary outcomes were postoperative complications, including anastomotic leak, surgical site infection, and Clavien-Dindo complication rate. Total operative time, conversion to open surgery, intra-operative blood loss, intensive therapy unit (ITU) and total hospital length of stay (LOS), oncological outcomes and functional outcomes were the other evaluated outcome parameters.A total of 12 studies with a total number of 3025 patients divided between rTME (n = 1881) and TaTME (n = 1144) groups were included. There was no significant difference between the two groups for total operative time (P = 0.39), conversion to open surgery (P = 0.29) and intra-operative blood loss (P = 0.62). Clavien-Dindo ≥ 3 complication rate (P = 0.47), anastomotic leak (P = 0.89), rates of re-operation (P = 0.62) and re-admission (P = 0.92), R0 resections (P = 0.52), ITU LOS (P = 0.63) and total hospital LOS (P = 0.30) also showed similar results between the two groups. However, the rTME group had higher rates of total harvested lymph nodes (P = 0.04) and complete total mesorectal excision (TME) resections (P = 0.05). Albeit with a limited dataset, the Wexner and low anterior resection syndrome (LARS) scores showed better functional results in the rTME group compared with the TaTME group (P = 0.0009 and P = 0.00001, respectively).Compared with TaTME, rTME seems to provide better functional outcomes, higher lymph node yield and more complete TME resections with a similar post-operative complications profile.© 2024. Springer Nature Switzerland AG.