TaTME直肠癌手术的新突破腹腔镜TME手术的肿瘤根治效果（腹腔镜手术3年局部复发率、无病存活率、总存活率）与开放手术相似。BonjerHJ,DeijenCL,AbisGA.Arandomizedtrialoflaparoscopiclaparoscopicvesusopensurgeryforrectalcancer［J］.NEnglJMed,2015,372(14):1324-1332.Currentstatusoftrans-analtotalmesorectalexcision(TaTME)followingtheSecondInternationalConsensusConferencepublishedinColorectalDiseasethink:Thechallengeofoperatinginthedeeppelvisisconfirmedbyresultsofarecentrandomizedcontrolledtrialshowinga10%positivecircumferentialradialmarginrateinlaparoscopicandopenTMEandinparticularaconcerning22%positivecircumferentialradialmarginrateinthelowerrectumintheopenarmofthetrial[1].Furthermore,theneedformultiplefiringsoflinearstaplingdevicesinlowrectaldivisionhasbeenassociatedwithanincreaseinthesurgicalmorbidityoftheprocedure[2].1vanderPasMHGM,HaglindE,CuestaMA,FurstA,LacyAM,HopWCJ.BonjerHJLaparoscopicversusopensurgeryforrectalcancer(COLORII):short-termoutcomesofarandomised,phase3trial.LancetOncol2013;14:210–8.2ItoM,SugitoM,KobayashiA,NishizawaY,TsunodaY,SaitoN.Relationshipbetweenmultiplenumbersofstaplerfiringsduringrectaldivisionandanastomoticleakageafterlaparoscopicrectalresection.IntJColorectalDis2008;23:703–7.Tatme适应证TaTME操作平台经肛门微创手术（ＴＡMＩＳ）平台商品化的经肛门单孔通道和经肛门内镜显微手术（ＴＥM）平台的直肠镜TEM与TAMIS平台的比较TaTME手术步骤TATME与腹腔镜辅助TME比较Heald认为tatme的最大优势之一是解决了既往TME术中对中下段直肠系膜周围间隙暴露不佳而造成的盆腔神经副损伤。HealdRJ.Anewsolutiontosomeoldproblems:transanalTME［J］.TechColoproctol，2013，17(3):257-258.TransanalTATA/TME:acase-matchedstudyoftaTMEversuslaparoscopicTMEsurgeryforrectalcancerTransanalTATA/TME:acase-matchedstudyoftaTMEversuslaparoscopicTMEsurgeryforrectalcancerTransanalTATA/TME:acase-matchedstudyoftaTMEversuslaparoscopicTMEsurgeryforrectalcancerConclusions：Wedemonstratednodifferencesinperioperative/postoperativeoutcomesorpathologicTMEoutcomesoftransanalorbottoms-upTMEcomparedtostandardlaparoscopicTME.TaTMEisapromisingprogressiveapproachtoNOTESanddeservesadditionalevaluation.Transanaltotalmesorectalexcision:surgicaltechniquedescriptionandoutcomesConclusions：Transanaltot