Comparison of Anastomotic Stricture/Stenosis After Transanal Total Mesorectal Excision for Rectal Cancer with Laparoscopic Total Mesorectal Excision

Anastomotic stricture/stenosis is an alarming complication developing after colorectal surgery. The purpose of this study was to compare the severity of anastomotic stricture/stenosis developing after transanal total mesorectal excision to that developing after laparoscopic total mesorectal excision. This research included patients with confirmed rectal adenocarcinoma who underwent transanal total mesorectal excision or laparoscopic total mesorectal excision with stapled anastomosis at Shengjing Hospital of China Medical University from March 2018 to June 2021. For comparison of anastomotic stricture/stenosis at 1, 3, and 6 months after surgery, a special stricture/stenosis grading system was adopted. A total of 41 patients (21 who underwent transanal total mesorectal excision and 20 who underwent laparoscopic total mesorectal excision, all with defunctioning stoma) received neoadjuvant radiotherapy, and 172 patients (86 patients underwent transanal total mesorectal excision, and the remaining 86 underwent laparoscopic total mesorectal excision, with 55 of the former and 49 of the latter receiving defunctioning stoma) did not receive radiotherapy which were enrolled in the study. The severity of the stricture was graded at 1, 3, and 6 months after surgery. For patients who did not receive radiotherapy, anastomotic stricture/stenosis developing after transanal total mesorectal excision was more severe than that developing after laparoscopic total mesorectal excision during the follow-up period (all p 0.05), and compared with patients who did not receive radiotherapy, more severe degrees of anastomotic stricture/stenosis were observed (all p