Comparison of Transanal Versus Laparoscopic Total Mesorectal Excision in Low Rectal Cancer

Introduction: transanal total mesorectal excision (tatme) presented in recent years as a novel technique to achieve better outcome in circumferential margin (crm) and distal margin (drm) in lower rectal cancer operation. the current study aimed to assess the perioperative and pathological characteristics of tatme in comparison with laparoscopic total mesorectal excision (latme) in patients with mid- and low-rectal cancer. methods: from january 2016 to december 2018, we enrolled all consecutive patients with rectal cancer, who underwent tatme and latme. primary endpoints like circumferential rectal margin (crm) status, distal rectal margin (drm) status, and pathological outcomes, as well as secondary endpoints including perioperative outcomes (total blood loss, duration of hospitalization, anastomosis leakage, as well as 30-day mortality) were evaluated and compared statistically (α=0.05). results: 11 patients with distal rectal adenocarcinoma which was biopsy-proven, underwent tatme, and 19 patients operated on using latme. both groups were similar in the baseline characteristics. also, the perioperative outcomes were similar in both groups. regarding pathological outcomes, no patients with crm<1mm were found in the latme group compared to 1 patient in tatme group. involvement of drm was observed in only one patient in both groups. conclusion: tatme is a reasonable procedure in patients with low rectal cancer. but no remarkable superiority was observed in this method compared to laparoscopy with respect to the pathological outcomes.