Abstract:

Typically, TME is performed after nCRT to ensure tumour shrinkage and allow for a smoother and more thorough procedure.For a long time, low rectal cancer has always been the difficulty of surgical treatment in colorectal surgery, and there are mutual constraints and contradictions between radical resection and functional protection.In recent years, with the development of transanal endoscopic microsurgery and other surgical techniques, transanal total mesorectal excision (TaTME) surgery is also widely used in clinical practice.Previous studies have shown that traditional nCRT combined with immunotherapy has even significantly increased the pathological complete remission rate (pCR), which also makes it difficult to accurately identify the tumour location intraoperatively.The magnifying effect of laparoscopy and transanal endoscopy allows fine manipulation of the pelvic floor and clarification of the surgical anatomy of the anal canal.TaTME may be more advantageous in rectal cancer patients with ‘difficult pelvis’ such as low anterior rectal wall tumours, pelvic stenosis, and unclear tissue planes due to neoadjuvant radiotherapy.

Key words: Low and Intermediate Rectal Cancer, Neoadjuvant Radiotherapy, Transanal Total Mesorectal Excision