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Rectal Neoplasms MalignantNCT02966483

Transanal Versus Laparoscopic Total Mesorectal Excision For Rectal Cancer

A study testing TaTME and LpTME in people with Rectal Neoplasms Malignant and Surgery, run by Sun Yat-sen University at 16 sites in China.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Laparoscopic surgery for rectal cancer has been successfully proven to be a non-inferior alternative regarding resection quality, and oncological outcomes of patients as compared to open surgery in mangy clinical trails. Read more about this study

Who is it for?
Ages 18 to 75 years
Conditions the study is for
Rectal Neoplasms Malignant, Surgery
What is being tested?
TaTME and LpTME
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
1,115 participants
Where
16 sitesChina
Study dates
Apr 2016to Sep 2026
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • histologically proven rectal adenocarcinoma;
  • tumor located below the level of peritoneal reflection ;
  • diagnosis of rectal cancer amenable to curative surgery;
  • no evidence of distant metastases;
  • preoperative tumor stage within III;
  • no threaten mesorectal fascia (MRF)after neoadjuvant therapy;
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  • no contraindication to laparoscopic surgery;
  • without history of other malignancies;
  • Written informed consent

Who cannot join

  • could not perform sphincter preservation surgery (requiring a Mile's procedure);
  • T4b tumor invading adjacent organs;
  • T1 tumors that can be locally resected
  • should take neoadjuvant therapy but refuse it;
  • recurrent cancer;
  • concurrent or previous diagnosis of invasive cancer within 5 years;
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  • emergent surgery with intestinal obstruction or perforation;
  • history of colorectal surgery;
  • fecal incontinence;
  • history of inflammatory bowel disease;
  • with contraindications to general anaesthesia(ASA class 4 or 5);
  • pregnant or breast-feeding;
  • history of mental disorder

Trial locations and contacts

16 sites in 1 country.

16 sites in 1 country

China16 sites
  • Department of General Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences

    Beijing, Beijing Municipality, 100730

  • Department of Gastrointestinal Surgery, The First Hospital of Jilin University

    Changchun, Jilin, 130021

  • The Third Xiangya Hospital of Central South University

    Changsha, Hunan, 410013

  • Department of General Surgery, Daping Hospital, Army Medical university

    Chongqing, Chongqing Municipality, 400042

  • XinQiao Hospital of Army Medical University

    Chongqing, 400037

  • Department of colorectal surgery, the Sixth Affiliated Hospital, Sun Yat-Sen University

    Guangzhou, Guangdong, 510000

  • Nanfang Hospital

    Guangzhou, Guangdong, 510559

  • The First Affiliated Hospital of University of South China

    Hengyang, Hunan, 421001

  • Department of Gastrointestinal Surgery,The Affiliated Nanchong Central Hospital of North Sichuan Medical College

    Nanchong, Sichuan, 637000

  • Ruijin Hospital, Shanghai Jiao Tong University School of Medicine

    Shanghai, Shanghai Municipality, 200025

  • Department of Gastrointestinal Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University,

    Shanghai, Shanghai Municipality, 200127

  • Department of Colorectal Surgery, Shengjing Hospital of China Medical University

    Shenyang, Liaoning, 110004

  • The First Affiliated Hospital of Xi'an Jiaotong University

    Xi'an, Shaanxi, 710061

  • Department of gastrointestinal surgery, the Second People's Hospital of Yibin

    Yibin, Sichuan, 644000

  • The Affiliated Hospital of Guangdong Medical University

    Zhanjiang, Guangdong, 524001

  • Affiliated Hospital of Zunyi Medical University

    Zunyi, Guizhou, 563003

Other trials in China

About this study

Official title: Transanal Versus Laparoscopic Total Mesorectal Excision For Mid And Low Rectal Cancer (TaLaR): A Multicentre Randomised Clinical Trial

Laparoscopic surgery for rectal cancer has been successfully proven to be a non-inferior alternative regarding resection quality, and oncological outcomes of patients as compared to open surgery in mangy clinical trails. Moreover, laparoscopic surgery is advantageous over open surgery with regard to operative invasiveness, patient's recovery, and wound related complications. Thus, laparoscopic surgery has gained great popularity over the past decades. However, specifically for mid and low rectal cancer, laparoscopic surgery is technically demanding, which sometimes leads to high morbidity and unsatisfactory resection quality, especially in challenging cases such as bulky mesorectum, enlarged prostate, irradiated pelvis, etc. Under this circumstance, transanal total mesorectal excision (TaTME) , the so called "down-to-up" alternative, has emerged as a promising solution to these problems in recent years and more and more small studies have proven the feasibility and advantages of this technique, making it become a hot topic among both literature and conferences. However, TaTME is still at early birth, higher-level evidences, either multicentric, or comparative study with conventional surgery is strikingly lacking. Thus the investigators conduct this multicentre randomised clinical trial, comparing transanal TME versus laparoscopic TME for mid and low rectal cancer, aiming to prove the hypothesis that TaTME may achieve better resection quality and result in non-inferior oncological outcome, as well as short term operative morbidity and mortality.

Read the detailed description

Background:In recent years, transanal mesorectal excision (TaTME) has emerged as a promising surgical alternative for rectal cancer, especially for mid and low rectal cancer. Theoretically, TaTME holds the potential advantage of providing better access to mobilize the distal rectum, and thus could achieve better pathologic outcomes, such as lower involved circumferential margin (CRM) and incomplete resected mesorectum, which could translate into better oncological outcome for the patients in the long term. However, until now, the feasibility and the non-inferiority (compared with laparoscopic total mesorectal excision, LpTME) of this technique has only been validated in studies with limitations of small sample size, retrospective nature.

Study Objective:This study aims to evaluate the TaTME technique compared with conventional laparoscopic rectal surgery, focusing on resection quality, as well as long-term survival results.

Study design This study is a prospective, multi-center, randomized, open-label, parallel group trial. The randomisation ratio of TaTME over LpTME will be 1:1. A central electronic data capture (EDC) system will be utilized for randomization, electronic CRF and data collection. All comparative analyses will be conducted on an "intention to treat" basis.

Sample size: Sample-size calculation of this trial based on 3-year DFS and 5-year OS; but the sample size according to 5-year OS was larger than that based on 3-year DFS. The expected 5-year OS among clinical stage I-III rectal cancer patients treated with laTME was 77·4%. Allowing a difference of 10% as the non-inferiority margin, 910 patients would be required to sufficiently declare taTME noninferior to laTME in 5-year OS based on a log-rank test with an α error of 2·5% (in a two-sided test) and power of 80%. Assuming a dropout rate of 20%, a total of 1114 patients were planned to enroll for this trial.

Study Endpoints:The primary end point of this study is 3-year disease-free survival (DFS) rate and a 5-year overall survival (OS) rate. Secondary endpoints include: 1) resection quality, mainly including circumferential involvement rate, and completeness of mesorectum. Resected specimen was pathologically processed and assessed at each center by trained and qualified pathologists independently.2)short term operative results such as morbidity and mortality, etc.; 3) long term oncological outcome such as local recurrence, and overall survival. Besides, functional outcome and quality of life are also evaluated.

Being tested
TaTME, LpTME
Keywords
Rectal cancer, Laparoscopic surgery, Total mesorectal excision, Transanal, Multicentre randomised clinical trial
Medical subject headings
Rectal Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • TaTMEProcedure or surgery

    Also called Transanal TME

    Transanal Total Mesorectal Excision

  • LpTMEProcedure or surgery

    Also called Laparoscopic TME

    Conventional Laparoscopic Total Mesorectal Excision

Study groups in NCT02966483
Study groupRoleWhat they receive
Transanal Total Mesorectal ExcisionExperimentalThe rectum is mobilized and resected transanally (from bottom to up) according to TME principles, via transanal platform (either rigid or flexible platform).An ideal TaTME is defined as the extraperitoneal portion of the rectum being mobilized from below.
Receives: Procedure: TaTME
Laparoscopic Total Mesorectal ExcisionActive comparatorThe traditional laparoscopic TME (LpTME) was performed via standard laparoscopic techniques, including multiple trocars and conventional laparoscopic instruments.
Receives: Procedure: LpTME

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Disease-free survival

    Disease-free survival

    Measured: 3 years

  2. Overall survival

    Overall survival

    Measured: 5 years

Secondary outcomes (9)
  1. Positive circumferential resection margin (CRM)

    Involved CRM (tumor cells <1mm)

    Measured: 3 years

  2. Overall survival

    Overall survival

    Measured: 10 years

  3. Mesorectal completeness

    The quality of the mesorectum or TME specimen (complete;nearly complete; incomplete)

    Measured: 3 years

  4. Number of retrieved lymph nodes

    Number of retrieved lymph nodes

    Measured: 3 years

  5. Morbidity rate

    Morbidity rate

    Measured: 1 years

  6. Mortality rate

    Mortality rate

    Measured: 1 years

  7. Anorectal function outcomes

    To evaluate defecating function with Wexner score

    Measured: 3 years

  8. Sexual functional outcomes

    To evaluate sexual function with IIEF(International Index of Erectile Function) questionnaire

    Measured: 3 years

  9. The patient's Quality of life: EORTC QLQ-30 questionnaire

    To evaluate quality of life with EORTC QLQ-30 questionnaire

    Measured: 3 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted17 Nov 2016 (estimated)
  2. Study startApr 2016
  3. Primary completionSep 2026
  4. Study completionSep 2026

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Transanal or Laparoscopic Total Mesorectal Excision treat rectal cancer
Masking
None (open label)
Enrolment
1,115 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02966483
Sponsor's protocol ID
SYSU-RECTAl-2016
Status last verified
Oct 2026
First submitted
8 Nov 2016
Last updated
16 Oct 2026
Results posted
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Chen WH, Kang L, Luo SL, Zhang XW, Huang Y, Liu ZH, Wang JP. Transanal total mesorectal excision assisted by single-port laparoscopic surgery for low rectal cancer. Tech Coloproctol. 2015 Sep;19(9):527-34. doi: 10.1007/s10151-015-1342-1. Epub 2015 Jul 29.

    PubMed 26220109
  • Kang L, Chen WH, Luo SL, Luo YX, Liu ZH, Huang MJ, Wang JP. Transanal total mesorectal excision for rectal cancer: a preliminary report. Surg Endosc. 2016 Jun;30(6):2552-62. doi: 10.1007/s00464-015-4521-2. Epub 2015 Aug 27.

    PubMed 26310534
  • Zeng Z, Luo S, Zhang H, Wu M, Ma D, Wang Q, Xie M, Xu Q, Ouyang J, Xiao Y, Song Y, Feng B, Xu Q, Wang Y, Zhang Y, Shi L, Ling L, Zhang X, Huang L, Yang Z, Peng J, Wu X, Ren D, Huang M, Lan P, Wang J, Tong W, Ren M, Liu H, Kang L; Chinese Transanal Endoscopic Surgery Collaborative (CTESC) Group. Transanal vs Laparoscopic Total Mesorectal Excision and 3-Year Disease-Free Survival in Rectal Cancer: The TaLaR Randomized Clinical Trial. JAMA. 2025 Mar 4;333(9):774-783. doi: 10.1001/jama.2024.24276.

    PubMed 39847361
  • Chen M, Ye F, Huang P, Liang Z, Liu H, Zheng X, Li W, Luo S, Kang L, Huang L. Inflammatory stress response after transanal vs laparoscopic total mesorectal excision: a cohort study based on the TaLaR trial. Int J Surg. 2024 Jan 1;110(1):151-158. doi: 10.1097/JS9.0000000000000838.

    PubMed 37916926
  • Zeng Z, Luo S, Chen J, Cai Y, Zhang X, Kang L. Comparison of pathological outcomes after transanal versus laparoscopic total mesorectal excision: a prospective study using data from randomized control trial. Surg Endosc. 2020 Sep;34(9):3956-3962. doi: 10.1007/s00464-019-07167-1. Epub 2019 Oct 4.

    PubMed 31586244

Questions about this trial

What is this clinical trial studying?

A study testing TaTME and LpTME in people with Rectal Neoplasms Malignant and Surgery, run by Sun Yat-sen University at 16 sites in China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 9 inclusion and 13 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 16 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 16 sites in China. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Disease-free survival (time frame: 3 years). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02966483, which also lists 5 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 16 Oct 2026.

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