Transanal Transection and Single Stapled Anastomosis as A Reliable Technique for Distal Rectum Transection in Patients Undergoing Low Anterior Resection for Rectal Cancer

Purpose To evaluate the safety, feasibility, and oncological and functional outcomes of the TTSS technique in rectal cancer surgery. Methods This retrospective study included 23 patients who underwent TTSS for rectal cancer. Data on demographics, tumor characteristics, perioperative variables, and postoperative outcomes were collected. Oncological parameters, anastomotic integrity, and functional outcomes were assessed. Short-term complications and early functional results were evaluated. Results The mean patient age was 48.87 ± 15.91 years, with a mean BMI of 25.22 ± 4.86 kg/m². Laparoscopic surgery was performed in 91.3% of cases, with no conversions to open surgery. The anastomotic leakage rate was 4.3%, managed conservatively. Anastomotic strictures developed in 13% of cases, requiring endoscopic dilation. The average operative time was 287.83 ± 38.70 minutes, and estimated blood loss was 195.65 ± 82.45 ml. The 30-day complication rate was 17.4%, with no major surgical re-interventions. Pathological complete response was achieved in 26.1% of cases, and 87% had negative lymph node involvement. Among patients who underwent ileostomy closure, 85% had complete continence, while 15% experienced minor incontinence symptoms. Conclusion TTSS is a feasible and safe technique for rectal cancer surgery, demonstrating favorable oncological outcomes, a low anastomotic leakage rate, and promising functional results.