Comparing the long‐term follow‐up anal function between robot‐assisted and laparoscopic surgery for low rectal cancer: A meta‐analysis and systematic review

Abstract Background Robotic‐assisted surgery (RAS) is increasingly used for treating low rectal cancer. Its comparative effectiveness against laparoscopic surgery (LAS) in enhancing long‐term anal function remains uncertain. Methods A meta‐analysis was conducted to compare long‐term anal function outcomes between patients undergoing RAS and LAS. Meta‐regression and sensitivity analyses were performed to assess available evidence. Studies published up to September 2023 in English or Chinese were included. Results Seven studies were identified. RAS patients exhibited lower low anterior resection syndrome (LARS) scores (standardised mean difference [SMD] = −1.39; 95% confidence interval [CI]: −2.64 to −0.15) and Wexner scores (SMD = −0.74; 95% CI: −1.20 to −0.27) compared with LAS patients. However, RAS did not significantly reduce major LARS risk (odds ratio = 0.85; 95% CI: 0.68–1.04). Conclusions RAS slightly improved postoperative anal function compared with LAS. Further studies with large samples are warranted to confirm or update our findings.