{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T13:53:15Z","timestamp":1791985995823,"version":"4.4.0"},"reference-count":25,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of Gastroent Surgery"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To evaluate the association between preoperative neoadjuvant therapy and short\u2010term outcomes of transanal total mesorectal excision for rectal cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed patients who underwent transanal total mesorectal excision at 26 Japanese institutions between 2012 and 2019. Patients who received neoadjuvant therapy were matched 1:1 with patients who did not. Perioperative, postoperative, and pathological outcomes were compared.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After matching, 294 patients (147 per group) were analyzed. Operative time was longer in the neoadjuvant therapy group than in the non\u2010neoadjuvant therapy group (median, 510.0 vs. 382.0\u2009min), with an adjusted mean difference of 129.25\u2009min (95% CI, 87.90\u2013170.59;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Clavien\u2013Dindo grade \u2265\u2009III complications occurred in 18\/147 patients (12.2%) without neoadjuvant therapy and 16\/147 (10.9%) with neoadjuvant therapy (adjusted OR, 0.90; 95% CI, 0.44\u20131.85;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.769). Full\u2010cohort conventional and Firth logistic analyses and marginal standardization likewise did not identify a statistically significant association. Neoadjuvant therapy remained associated with longer operative time after adjustment for operative procedure, lateral pelvic lymph node dissection, and abdominal approach. Resection\u2010margin involvement did not differ significantly between groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Neoadjuvant therapy was associated with longer operative time during transanal total mesorectal excision, whereas no statistically significant association with severe postoperative morbidity was detected. Sensitivity analyses likewise did not identify a statistically significant association, supporting the technical feasibility of transanal total mesorectal excision after neoadjuvant therapy in experienced centers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ags3.70298","type":"journal-article","created":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T13:35:41Z","timestamp":1791984941000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Short\u2010Term Outcomes of Transanal Total Mesorectal Excision for Rectal Cancer: A Multicenter Propensity Score\u2010Matched Analysis Comparing Patients With and Without Preoperative Neoadjuvant Therapy"],"prefix":"10.1002","author":[{"given":"Takafumi","family":"Shima","sequence":"first","affiliation":[{"name":"Department of General and Gastroenterological Surgery Osaka Medical and Pharmaceutical University  Takatsuki\u2010shi Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2294-4673","authenticated-orcid":false,"given":"Hiroki","family":"Hamamoto","sequence":"additional","affiliation":[{"name":"Department of General and Gastroenterological Surgery Osaka Medical and Pharmaceutical University  Takatsuki\u2010shi Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9541-856X","authenticated-orcid":false,"given":"Takeru","family":"Matsuda","sequence":"additional","affiliation":[{"name":"Division of Gastrointestinal Surgery, Department of Surgery Kobe University Graduate School of Medicine  Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1595-2453","authenticated-orcid":false,"given":"Ichiro","family":"Takemasa","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery, Osaka International Medical and Science Center Osaka Keisatsu Hospital  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keitaro","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Department of General and Gastroenterological Surgery Osaka Medical and Pharmaceutical University  Takatsuki\u2010shi Osaka Japan"},{"name":"Department of General, Breast and Digestive Surgery Otsu City Hospital  Otsu Shiga Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3553-3590","authenticated-orcid":false,"given":"Toshiki","family":"Mukai","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Cancer Institute Hospital of Japanese Foundation for Cancer Research  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7187-3664","authenticated-orcid":false,"given":"Jun","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Kansai Medical University  Hirakata Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang\u2010Woong","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of General and Gastroenterological Surgery Osaka Medical and Pharmaceutical University  Takatsuki\u2010shi Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seiichiro","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery Tokai University School of Medicine  Isehara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4169-6334","authenticated-orcid":false,"given":"Takeshi","family":"Naitoh","sequence":"additional","affiliation":[{"name":"Department of Lower Gastrointestinal Surgery Kitasato University School of Medicine  Sagamihara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Ta\u2010Ta\u2010Mi Study Group Collaborators from the Japan Society of Laparoscopic Colorectal Surgery","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,14]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1002\/bjs.1800691019","article-title":"The Mesorectum in Rectal Cancer Surgery\u2014The Clue to Pelvic Recurrence?","volume":"69","author":"Heald R. J.","year":"1982","journal-title":"British Journal of Surgery"},{"key":"e_1_2_13_3_1","doi-asserted-by":"crossref","first-page":"1193","DOI":"10.21037\/jgo.2019.01.13","article-title":"Transanal Total Mesorectal Excision for Rectal Cancer: Hype or New Hope?","volume":"10","author":"Chen C.\u2010C.","year":"2019","journal-title":"Journal of Gastrointestinal Oncology"},{"key":"e_1_2_13_4_1","doi-asserted-by":"crossref","first-page":"341","DOI":"10.7150\/jca.27830","article-title":"Short\u2010Term Outcomes of Transanal Versus Laparoscopic Total Mesorectal Excision: A Systematic Review and Meta\u2010Analysis of Cohort Studies","volume":"10","author":"Wu Z.","year":"2019","journal-title":"Journal of Cancer"},{"key":"e_1_2_13_5_1","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1001\/jamaoncol.2025.2026","article-title":"Total Neoadjuvant Therapy for Locally Advanced Rectal Cancer","volume":"11","author":"Audisio A.","year":"2025","journal-title":"JAMA Oncology"},{"key":"e_1_2_13_6_1","doi-asserted-by":"crossref","DOI":"10.3389\/fimmu.2026.1792283","article-title":"Neoadjuvant Chemoradiotherapy With or Without PD\u20101 Inhibitors in MMR\u2010Proficient Non\u2010Metastatic Rectal Cancer: A Meta\u2010Analysis of Randomized Controlled Trials","volume":"17","author":"Li Y.","year":"2026","journal-title":"Frontiers in Immunology"},{"key":"e_1_2_13_7_1","doi-asserted-by":"crossref","first-page":"2686","DOI":"10.1097\/JS9.0000000000002262","article-title":"Comparison of the Efficacy of Neoadjuvant Chemotherapy and Neoadjuvant Chemoradiotherapy in Locally Advanced Rectal Cancer Patients: Meta\u2010Analysis of Randomized Controlled Trials","volume":"111","author":"Zeng D.\u2010X.","year":"2025","journal-title":"International Journal of Surgery"},{"key":"e_1_2_13_8_1","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1097\/SLA.0000000000003227","article-title":"Open Versus Laparoscopic Versus Robotic Versus Transanal Mesorectal Excision for Rectal Cancer: A Systematic Review and Network Meta\u2010Analysis","volume":"270","author":"Simillis C.","year":"2019","journal-title":"Annals of Surgery"},{"key":"e_1_2_13_9_1","doi-asserted-by":"crossref","first-page":"6998","DOI":"10.1007\/s00464-020-08213-z","article-title":"Comparison of Transanal Total Mesorectal Excision and Robotic Total Mesorectal Excision for Low Rectal Cancer After Neoadjuvant Chemoradiotherapy","volume":"35","author":"Shin J. 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X.","year":"2021","journal-title":"International Journal of Surgery Open"}],"container-title":["Annals of Gastroenterological Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ags3.70298","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ags3.70298","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ags3.70298","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T13:35:46Z","timestamp":1791984946000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ags3.70298"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,14]]},"references-count":25,"alternative-id":["10.1002\/ags3.70298"],"URL":"https:\/\/doi.org\/10.1002\/ags3.70298","archive":["Portico"],"relation":{},"ISSN":["2475-0328","2475-0328"],"issn-type":[{"value":"2475-0328","type":"print"},{"value":"2475-0328","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,14]]},"assertion":[{"value":"2026-08-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"ags3.70298"}}