Technical difficulty did not worsen TaTME cancer outcomes

In this 210-patient multicenter cohort, higher technical difficulty during TaTME prolonged operating time but was not associated with worse recurrence or survival outcomes.

• Operating time was 249 vs 220 minutes for high- vs low-difficulty cases.
• Overall recurrence was 21.2% vs 17.7%; local recurrence was 2.5% vs 3.8%. Three-year disease-free and overall survival were 80.2% and 89.0%.

Most recurrences were distant, and most occurred within two years. The retrospective study is too small to rule out clinically important differences, but it offers no evidence that technical difficulty alone predicts poorer oncologic outcomes.