Patients with resectable mid–low rectal cancers often undergo total mesorectal excision (TME) surgery. Over the past decade, considerable research interest has been focused on minimally invasive TME procedures that might offer improved perioperative outcomes and preservation of sphincter function, including laparoscopic and transanal approaches. Despite some evidence of an increased risk of local recurrence with the transanal approach, only limited data on long-term outcomes are available. Now, data from the phase III TaLaR trial indicate similar 3-year survival outcomes among patients undergoing these procedures.

A total of 1,115 patients with stage I–III mid–low rectal cancer (located within 10 cm of the rectal verge) requiring TME surgery were randomly assigned (1:1) to undergo transanal or laparoscopic TME across 16 centres in China. Noninferior 3-year disease-free survival (DFS) was the primary end point.