To observe clinical outcome of laparoscopic trans-anal total mesorectal resection (TaTME) and total mesorectal resection (TME) in patients with low rectal cancer.

From May 2014 to November 2016, clinical data of 83 patients with low rectal cancer who received TME were retrospectively analyzed, including 41 patients in TaTME group and 42 patients in TME group. Statistical analysis were performed by using SPSS 21.0 software. Measurement data, such as gastrointestinal indexes and anal function score were expressed as (±s), and were examined by independent test. Count data such as postoperative complications were examined by chi square test. Kaplan-meier method was used for survival analysis and log-rank test was performed. A P value <0.05 was considered as statistically significant difference.

The operation time and blood loss in TaTME group were more than those in TME group, and the postoperative recovery indexes were better than those in TME group respectively (P<0.05). The total incidence of complications was 7.3% in TaTME group and 19.0% in TME group (P<0.05). One month after the operation, serum motilin and gastrin levels in the two groups decreased to different degrees, and TaTME group was superior to TME group (P<0.05). 6 months after surgery, Wexner score of patients in TaTME group was significantly lower than that of TME group (P<0.05). At 12 months after surgery, there was no difference in scores between the two groups (P>0.05). Six months after surgery, Comparison of Kirwan grading of anal function between the two groups showed that the rate of good anal function in TaTME group was better than that in TME group (P<0.05). Kaplan-meier survival analysis found no significant difference in local recurrence rate, distant metastasis rate and survival rate between the two groups on 2 years after surgery (P>0.05).

Laparoscopic TaTME in the treatment of low rectal cancer is safe and feasible, and its overall efficacy is better than that of TME, which could be widely used in clinical application.