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Transanal versus laparoscopic total mesorectal excision for mid and low rectal cancer (Ta-LaTME study): multicentre, randomized, open-label trial.

Serra-Aracil X, Zarate A, Bargallo J, Gonzalez A, Serracant A, Roura J et al for the Ta-LaTME study Group.

Br J Surg 2023; 110: 150–158.

This study included 105 evaluable patients. Conversion to open surgery was needed after 20 per cent of transanal, versus 2 per cent of laparoscopic procedures, P=0.003. Morbidity rates, and postoperative recovery were similar. After a median of 39 months recurrence rates were similar: 6.1 percent laparoscopic, and 1.8 per cent transanal surgery.

Comment: This is a brave study, but really too small to answer many of the questions that remain about TaTME. Longer term follow-up will be important.

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