BACKGROUND: Laparoscopic total mesorectal excision (LaTME) has improved short-term outcomes of rectal cancer surgery with comparable oncological results to open approach. LaTME can be difficult in the lower most part of the rectum, leading potentially to higher rates of complications, conversion to open surgery and probably suboptimal oncological quality. Transanal TME (TaTME) can potentially solve these problems. The aim of this study was to compare the short-term results after TaTME with those after LaTME.

METHODS: A prospectively collected database of consecutive patients who underwent TaTME was maintained. Results were compared with those underwent LaTME in the preceding period. Patients who underwent low anterior resection or intersphincteric abdominoperineal excision (APE) were included. Primary end-points were radical resection and specimen quality. Secondary end-points were complications, rates of conversion, operating time and hospital stay.

RESULTS: In total, 50 patients were included (TaTME = 25, LaTME = 25). The groups were comparative in demographic data and tumour characteristics. Circumferential resection margin was positive in one patient in TaTME group versus four patients in LaTME group (P=0.349). All patients in TaTME group had either complete or nearly complete specimen quality, while four patients in LaTME group had incomplete specimen quality (P=0.113). Less blood loss, shorter operating time and shorter hospital stay were found in TaTME group (P values 0.016, 0.002 and 0.020 respectively). Intraoperative complications were comparable (P=0.286).

CONCLUSION: TaTME procedure had comparable pathological results and acceptable short-term postoperative outcomes compared to LaTME. This article is protected by copyright. All rights reserved.