Transanal Total Mesorectal Excision in Lower Rectal Cancer: Comparison of Short-Term Outcomes with Conventional Laparoscopic Total Mesorectal Excision

Background: Transanal total mesorectal excision (TaTME) is a novel technique to treat rectal cancer and also to obtain good-quality specimens. This study investigated the clinical results and perioperative and pathological outcomes of TaTME in lower rectal cancer treatment in comparison with laparoscopic total mesorectal excision (LaTME). Methods: During January 2014 to May 2017, all consecutive patients with lower rectal cancer who underwent TaTME were identified. This cohort study was matched for age, gender, American Society of Anesthesiology (ASA) score, and clinical staging with a cohort of patients who underwent conventional LaTME. Results: A total of 46 patients were analyzed in both groups. There were no significant differences in baseline characteristics between the groups. The estimated blood loss, duration of operation, and postoperative complications were also not different between both groups. Regarding pathological outcomes, no patients with circumferential margin (CRM) <1mm were observed in the TaTME group compared to 4 patients with CRM <1mm in the LaTME group (P=.037). Conclusion: TaTME is a safe and feasible procedure in this matched case-control study. TaTME had better pathological outcomes with CRM uninvolvement compared with laparoscopic surgery.