To compare the differences of the pathological features and the clinical-therapeutic effects of transanal total mesorectal excision (TaTME) and traditional laparoscopic total mesorectal excision (LaTME) techniques among low rectal cancer patients.

One hundred low rectal cancer inpatients treated in Zhongshan People' s Hospital were allocated into two groups randomly according to the treatment types: TaTME group (50 cases, adopted TaTME technique) and LaTME group (50 cases, adopted LaTME technique). All surgical specimens were examined histopathologically. After 1 year follow-up, the relevant indexes between the two groups were statistically analyzed: the positive rate of circumferential margin (CRM+), distal margin (DRM+), and lymph nodes; the average operation time, total blood loss, length of hospital stay, recovery time of intestinal function, rate of anus preservation, and the incidence of anastomotic leakage.

All operations went successfully. CRM+ and DRM+ in TaTME group and LaTME group were (10±2)% and (8±4)%, (8±2)% and (6±1)%, respectively, with no significant differences. The positive rate of lymph node detection in TaTME group was (80±6)%, which was higher than (60±8)% in LaTME group (P=0.041). The average operation time and anus preserving rate of TaTME group were (160±35) min, (80±10)%, which were higher than (120±26) min and (40±8)% of LaTME group (P<0.001). The total blood loss, length of hospital stay, recovery time of intestinal function and the incidence of anastomotic leakage in TaTME group were lower than those in LaTME group (P<0.05).

TaTME has significant advantages in the treatment of low rectal cancer. Compared with LaTME, TaTME can significantly improve the anal preservation rate and reduce the incidence of complications.