What question did this study set out to answer?

This research aims to compare long-term oncological outcomes between two surgical approaches for mid-low rectal cancer.

February 9, 2026Frontiers in Oncology0 citationsOpen Access

Long-term oncological outcomes of laparoscopic versus transanal total mesorectal excision for mid-low rectal cancer: a propensity score matching analysis

YXYang XieThe Affiliated Yongchuan Hospital of Chongqing Medical University ZWZiwei WangThe Affiliated Yongchuan Hospital of Chongqing Medical University HZH Y ZhangThe Affiliated Yongchuan Hospital of Chongqing Medical University

Key Points

This research aims to compare long-term oncological outcomes between two surgical approaches for mid-low rectal cancer.
Analyzed 233 patients treated for mid-low rectal cancer from July 2017 to August 2020
Compared outcomes between 110 taTME patients and 123 lapTME patients
Utilized propensity score matching to balance groups
Included 61 matched patients from each group for final comparison
Prior to propensity score matching, 5-year overall survival rates were 72.7% for taTME and 69.1% for lapTME
Disease-free survival rates before matching were 72% for taTME and 69% for lapTME
Post-matching, 5-year overall survival rates were 64.2% for taTME and 64.4% for lapTME
No statistically significant differences in overall survival and disease-free survival rates post-matching

Abstract

Background Transanal total mesorectal excision (taTME) has become a promising surgical approach for anus-preserving surgery of mid-low rectal cancer (RC). This study aimed to compare the long-term oncological outcomes of taTME and laparoscopic total mesorectal excision (lapTME). Methods Of 233 patients who were treated for mid-low RC from July 2017 to August 2020, 110 underwent taTME and 123 received lapTME. Propensity score matching (PSM) was performed to balance the baseline characteristics between the taTME and lapTME groups. After PSM, 61 patients were included in each group. Results Prior to PSM, the 5-year overall survival (OS) and disease-free survival (DFS) rates were comparable between the taTME and lapTME groups (72.7% vs . 69.1%, p = 0.617; 72% vs . 69%, p = 0.576, respectively). After PSM, there was no statistically significant difference in the 5-year OS and DFS rates between groups (64.2% vs . 64.4%, p = 0.936; 66.1% vs . 66.1%, p = 0.947, respectively). Conclusion As compared to lapTME, taTME achieved comparable oncological safety for patients with mid-low RC.

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