Objective: To systematically evaluate the efficacy and safety of robot-assisted proctectomy (RP) and laparoscopic proctectomy (LP) for rectal cancer.
Methods: The randomized controlled trials (RCTs) comparing RP and LP for rectal cancer were collected by searching several national and international databases from inception to March 28, 2018. The data were extracted and the quality was evaluated by two reviewers independently according to the inclusion and exclusion criteria. Meta-analysis was performed by using R version 3.4.2.
Results: Seven RCTs were finally included, involving 956 patients with 474 cases in RP group and 482 cases in LP group. The results of Meta-analysis showed that RP group had a longer operative time (MD=28.88, 95% CI=3.20–54.55, P=0.028), a lower conversion rate (RR=0.49, 95% CI=0.31–0.78, P=0.003), a faster recovery of postoperative bowel function (MD=–0.43, 95% CI=–0.74––0.13, P=0.006), and a shorter hospital stay (MD=–0.95, 95% CI=–1.84––0.06, P=0.037) compared with LP group; no significant differences were found in terms of perioperative mortality, incidence of complications, length of proximal and distal margins, harvested lymph nodes, time to liquid food intake between the two groups (all P>0.05). 
Conclusion: Current evidence indicates that the perioperative efficacy of RP is superior to that of LP. Regarding long-term efficacy of RP, the advantages can be not judged based on current research. To compare the long-term efficacy of RP and LP effectively, future RCTs should focus on long-term follow-up and record long-term outcomes between the two groups.