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  4. Vol 6, Issue 5, 2025

TaTME vs. LapTME in Mid-Low Rectal Cancer: Mid-term Outcomes and Selection Strategies

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DOI: 10.23977/medsc.2025.060517 | Downloads: 4 | Views: 18

Author(s)

Chen Su 1, Hongyu Zhang 1

Affiliation(s)

1 The First Affiliated Hospital of Chongqing Medical University, Chongqing, China

Corresponding Author

Hongyu Zhang

ABSTRACT

For mid-to-low rectal cancer (tumors ≤12 cm from the anal verge), total mesorectal excision (TME) remains the cornerstone of curative surgery. While laparoscopic TME (LapTME) is a well-established minimally invasive technique, transanal TME (TaTME) was developed to address the technical challenges of operating in a narrow pelvis. Current evidence shows no statistically significant difference in 3-year local recurrence rates between TaTME and LapTME in large, well-designed studies. Similarly, the two techniques demonstrate comparable outcomes in terms of 3-year overall survival (OS), disease-specific survival (DSS), and disease-free survival (DFS). Particularly for low rectal cancer, some studies even suggest that TaTME may show potential advantages in reducing the risk of death and disease recurrence. Additionally, TaTME has demonstrated benefits in specific scenarios—for example, in cases of low-lying tumors, it may help improve circumferential resection margin (CRM) positivity rates and reduce the need for conversion to open surgery. However, certain considerations must be addressed with TaTME, such as its unique learning curve effect. In summary, when performed by experienced surgeons, TaTME and LapTME can achieve equivalent 3-year local control and survival outcomes for mid-to-low rectal cancer. TaTME is a valuable option, especially in anatomically challenging cases, but its adoption requires careful attention to the learning curve and patient selection. Regardless of the surgical approach, the ultimate goal remains obtaining a high-quality TME specimen.

KEYWORDS

Rectal Cancer, Total Mesorectal Excision, TaTME, LapTME, Local Recurrence, Survival Outcomes, Minimally Invasive Surgery

CITE THIS PAPER

Chen Su, Hongyu Zhang, TaTME vs. LapTME in Mid-Low Rectal Cancer: Mid-term Outcomes and Selection Strategies. MEDS Clinical Medicine (2025) Vol. 6: 115-120. DOI: http://dx.doi.org/10.23977/medsc.2025.060517.

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