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Rigorous meta-analysis of 80 observational studies with dose-response modelling, clear effect sizes and confidence intervals, but observational design and surrogate indices limit practice-changing status.
Meta-analysis of 16 predominantly single-arm studies (540 patients) reports favorable pooled proportions for sphincter preservation (90%) and R0 resection (98%), but evidence is low-to-moderate certainty without direct RCT comparisons; confirmatory trials needed.