INTRODUCTION Since transanal total mesorectal excision (taTME) was introduced, it has become an important topic in rectal cancer treatment. Many previous studies reported positive relevant short-term results, histopathological results, and associated complications. Recently, concerns regarding the oncological safety of taTME have been raised due to reports showing high local recurrences (LR) rates. Therefore, this study aimed to compare the 3-year outcomes between taTME and laparoscopic total mesorectal excision (laTME) for mid-low rectal cancer. METHODS A total of 104 patients who underwent taTME were matched with 208 patients treated by laTME. The primary endpoint was 3-year LR rate; secondary endpoints in this matched-cohort study included the perioperative outcomes and histopathological outcomes. RESULTS taTME was associated with lower permanent ostomy rate (1% vs 13.5%) and lower conversion rate (0% vs 3.4%) compared to laTME. A similar quality of resected specimens was detected for each group. In both groups, the local recurrence rate was 3.8%. Within 3 years after surgery, the disease-free survival (DFS) rates were 78.8% in the taTME group and 76.9% in the laTME group (P = 0.640), while the overall survival (OS) rates were 93.3% in the taTME group and 89.9% in the laTME group (P = 0.327). CONCLUSION No significant differences regarding 3-year local recurrence rate (3.8%) were observed in the taTME group compared to laTME group.

中文翻译：

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经肛门全直肠系膜切除术与标准腹腔镜全直肠系膜切除术治疗中低位直肠癌的三年结果。

引言 自从引入经肛门全直肠系膜切除术 (taTME) 以来，它已成为直肠癌治疗中的一个重要课题。许多先前的研究报告了积极的相关短期结果、组织病理学结果和相关并发症。最近，由于显示局部复发率 (LR) 较高的报告，人们对 taTME 的肿瘤学安全性提出了担忧。因此，本研究旨在比较 taTME 和腹腔镜全直肠系膜切除术 (laTME) 治疗中低位直肠癌的 3 年结果。方法 共有 104 名接受 taTME 治疗的患者与 208 名接受 laTME 治疗的患者相匹配。主要终点是 3 年 LR 率；该匹配队列研究的次要终点包括围手术期结果和组织病理学结果。结果 与 laTME 相比，taTME 与较低的永久性造口率（1% 对 13.5%）和较低的转化率（0% 对 3.4%）相关。每组检测到相似质量的切除标本。两组局部复发率为3.8%。术后 3 年内，taTME 组的无病生存率 (DFS) 为 78.8%，laTME 组为 76.9% (P = 0.640)，而 taTME 组的总生存率 (OS) 为 93.3% laTME 组为 89.9%（P = 0.327）。结论 与 laTME 组相比，taTME 组的 3 年局部复发率 (3.8%) 没有显着差异。术后 3 年内，taTME 组的无病生存率 (DFS) 为 78.8%，laTME 组为 76.9% (P = 0.640)，而 taTME 组的总生存率 (OS) 为 93.3% laTME 组为 89.9%（P = 0.327）。结论 与 laTME 组相比，taTME 组的 3 年局部复发率 (3.8%) 没有显着差异。术后 3 年内，taTME 组的无病生存率 (DFS) 为 78.8%，laTME 组为 76.9% (P = 0.640)，而 taTME 组的总生存率 (OS) 为 93.3% laTME 组为 89.9%（P = 0.327）。结论 与 laTME 组相比，taTME 组的 3 年局部复发率 (3.8%) 没有显着差异。