直肠肿瘤的首选外科治疗是全直肠系膜切除术(TME)。经肛门入路在男性和肥胖病人、或骨盆狭窄和肿瘤较小的患者中可实现更好的手术操作。短期结果与腹腔镜或开放手术相当，但中长期肿瘤学数据不足。本研究旨在评估我们关于经肛门TME（TaTME）的早期经验。这是一项回顾性研究，对于在我们中心于2013年8月至2017年4月期间接受TaTME手术并随访≥3年的患者进行分析。分析包括病理学、并发症、死亡率、恶性肿瘤复发和无病生存。共纳入100名患者（男性68名，女性32名，中位年龄66.8岁[范围29.6-91.2岁]）。其中67例为T3病例（占67%），74例为N0病例（占74%），87.6%的患者肿瘤完全切除，仅检测到2例边缘侵犯（占2%）。中位随访期为47.6个月(范围11.8-78.9个月)。其中18例复发，其中3例(占3%)局部复发，平均无病期43.1个月。总生存率为80%，疾病进展导致的死亡率为13%。TaTME是一种安全的手术，其3年(中期)的手术、解剖病理和肿瘤学结果与腹腔镜和开放手术相当。需针对长期功能和生活质量结果进行更好的监测，如在5或10年时进行研究。 ©2023 Springer Nature Switzerland AG。

The surgical treatment of choice for rectal neoplasia is total mesorectal excision (TME). The transanal approach enables a better approach in male and obese patients and/or those with a narrow pelvis and in patients with small tumors. Short-term results are comparable with those for laparoscopy or the open approach, but the medium- and long-term oncological data are sparse. The aim of the present study was to evaluate our early experience with transanal TME (TaTME).This was a retrospective study conducted on patients who underwent TaTME at our center between August 2013 and April 2017 with a follow-up ≥ 3 years. Histopathology, complications, mortality, neoplastic recurrence and disease-free survival were analyzed.One hundred patients (68 men and 32 women,, median age 66.8 years [range 29.6-91.2 years]) were included. There were 67 T3 cases (67%) with 74 N0 cases (74%), the mesorectal quality was graded optimal for 87.6% and only 2 cases of radial margin involvement were detected (2%). The median follow-up period was 47.6 months (range 11.8-78.9 months). Eighteen cases of recurrence were diagnosed, of which 3 (3%) recurred locally with an average disease-free period of 43.1 months. Overall survival was 80% and mortality due to progression of disease was 13%.TaTME is a safe surgical procedure with surgical, anatomopathological and oncological results at 3 years (medium-term) comparable with those for the laparoscopic and open approaches. Better monitoring is required with studies of the long-term functional and quality of life outcomes, i.e., at 5 or 10 years.© 2023. Springer Nature Switzerland AG.