Robotic vs laparoscopic total mesorectal excision for rectal cancers: has a paradigm change occurred? A systematic review by updated meta‐analysis

Aim The debate about the oncological adequacy, safety and efficiency of robotic vs laparoscopic total mesorectal excision for rectal cancers continues. Therefore, an updated, traditional and cumulative meta‐analysis was performed with the aim of assessing the new evidence on this topic. Method A systematic search of the literature for data pertaining to the last 25 years was performed. Fixed‐ and random‐effects models were used to cumulatively assess the accumulation of evidence over time. Results Patients with a significantly higher body mass index (BMI), tumours located approximately 1 cm further distally and more patients undergoing neoadjuvant therapy were included in the robotic total mesorectal excision (RTME) cohort compared with those in the laparoscopic total mesorectal excision (LTME) cohort [RTME, mean difference (MD) = 0.22 (0.07, 0.36), P = 0.005; LTME, MD = −0.97 (−1.57, 0.36), P