{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T12:49:37Z","timestamp":1791982177901,"version":"4.4.0"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Surg Endosc"],"DOI":"10.1007\/s00464-026-13519-5","type":"journal-article","created":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T19:00:43Z","timestamp":1791831643000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of the transanal approach with the accuracy of distal margin achievement in rectal cancer surgery"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3543-1874","authenticated-orcid":false,"given":"Takuya","family":"Shiraishi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mizuki","family":"Endo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoya","family":"Ozawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chika","family":"Komine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuhisa","family":"Okada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akiharu","family":"Kimura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihiko","family":"Sano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Sakai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Shirabe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Saeki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,12]]},"reference":[{"issue":"8","key":"13519_CR1","doi-asserted-by":"publisher","first-page":"1331","DOI":"10.1007\/s11605-010-1165-3","volume":"14","author":"IJ Park","year":"2010","unstructured":"Park IJ, Kim JC (2010) Adequate length of the distal resection margin in rectal cancer: from the oncological point of view. J Gastrointest Surg 14(8):1331\u20131337. https:\/\/doi.org\/10.1007\/s11605-010-1165-3","journal-title":"J Gastrointest Surg"},{"issue":"7","key":"13519_CR2","doi-asserted-by":"publisher","first-page":"483","DOI":"10.1007\/s10151-016-1475-x","volume":"20","author":"S Atallah","year":"2016","unstructured":"Atallah S, Albert M, Monson JR (2016) Critical concepts and important anatomic landmarks encountered during transanal total mesorectal excision (taTME): toward the mastery of a new operation for rectal cancer surgery. Tech Coloproctol 20(7):483\u2013494. https:\/\/doi.org\/10.1007\/s10151-016-1475-x","journal-title":"Tech Coloproctol"},{"issue":"11","key":"13519_CR3","doi-asserted-by":"publisher","first-page":"7392","DOI":"10.1007\/s00464-025-12121-5","volume":"39","author":"L Zhao","year":"2025","unstructured":"Zhao L, Li L, Xiao D, Zhang X, Ouyang J, Chen X, Huang Q, Xiao S, Yi X (2025) Outcomes of transanal versus laparoscopic total mesorectal excision for rectal cancer: a meta-analysis and trial sequential analysis of matched cohort studies. Surg Endosc 39(11):7392\u20137406. https:\/\/doi.org\/10.1007\/s00464-025-12121-5","journal-title":"Surg Endosc"},{"issue":"10","key":"13519_CR4","doi-asserted-by":"publisher","first-page":"2101","DOI":"10.1007\/s00384-022-04239-y","volume":"37","author":"J Wlodarczyk","year":"2022","unstructured":"Wlodarczyk J, Kim D, Finney C, Gupta A, Cannom R, Duldulao M (2022) Inking outside the box: systematic review on the utility of tattooing lesions in rectal cancer. Int J Colorectal Dis 37(10):2101\u20132112. https:\/\/doi.org\/10.1007\/s00384-022-04239-y","journal-title":"Int J Colorectal Dis"},{"issue":"6","key":"13519_CR5","doi-asserted-by":"publisher","first-page":"2366","DOI":"10.1007\/s00464-016-5236-8","volume":"31","author":"SA Acuna","year":"2017","unstructured":"Acuna SA, Elmi M, Shah PS, Coburn NG, Quereshy FA (2017) Preoperative localization of colorectal cancer: a systematic review and meta-analysis. Surg Endosc 31(6):2366\u20132379. https:\/\/doi.org\/10.1007\/s00464-016-5236-8","journal-title":"Surg Endosc"},{"issue":"9","key":"13519_CR6","doi-asserted-by":"publisher","first-page":"1741","DOI":"10.1111\/codi.17109","volume":"26","author":"G Giuliani","year":"2024","unstructured":"Giuliani G, Matarazzo F, Guerra F, Benigni R, Marino MD, Coratti A (2024) Ultrasound assessment of the distal resection margin during robotic rectal surgery. Colorectal Dis 26(9):1741\u20131746. https:\/\/doi.org\/10.1111\/codi.17109","journal-title":"Colorectal Dis"},{"issue":"9","key":"13519_CR7","doi-asserted-by":"publisher","first-page":"774","DOI":"10.1001\/jama.2024.24276","volume":"333","author":"Z Zeng","year":"2025","unstructured":"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 (2025) Transanal vs laparoscopic total mesorectal excision and 3-year disease-free survival in rectal cancer: the TaLaR randomized clinical trial. JAMA 333(9):774\u2013783. https:\/\/doi.org\/10.1001\/jama.2024.24276","journal-title":"JAMA"},{"key":"13519_CR8","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpsurg.2025.101792","volume":"69","author":"S Hou","year":"2025","unstructured":"Hou S, Jiang S, Yu R, Hou H, Liu Z, Li L, Zhou T, Zhou H (2025) Comparison of efficacy and safety between TaTME and LaTME for middle and low rectal cancer: a meta-analysis of propensity score matching studies. Curr Probl Surg 69:101792. https:\/\/doi.org\/10.1016\/j.cpsurg.2025.101792","journal-title":"Curr Probl Surg"},{"issue":"4","key":"13519_CR9","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1093\/jjco\/hyy198","volume":"49","author":"D Shida","year":"2019","unstructured":"Shida D, Kanemitsu Y, Hamaguchi T, Shimada Y (2019) Introducing the eighth edition of the tumor-node-metastasis classification as relevant to colorectal cancer, anal cancer and appendiceal cancer: a comparison study with the seventh edition of the tumor-node-metastasis and the Japanese classification of colorectal, appendiceal, and anal carcinoma. Jpn J Clin Oncol 49(4):321\u2013328. https:\/\/doi.org\/10.1093\/jjco\/hyy198","journal-title":"Jpn J Clin Oncol"},{"issue":"3","key":"13519_CR10","doi-asserted-by":"publisher","first-page":"173","DOI":"10.3322\/caac.21138","volume":"62","author":"L Kosinski","year":"2012","unstructured":"Kosinski L, Habr-Gama A, Ludwig K, Perez R (2012) Shifting concepts in rectal cancer management: a review of contemporary primary rectal cancer treatment strategies. CA Cancer J Clin 62(3):173\u2013202. https:\/\/doi.org\/10.3322\/caac.21138","journal-title":"CA Cancer J Clin"},{"issue":"4","key":"13519_CR11","doi-asserted-by":"publisher","first-page":"589","DOI":"10.1097\/SLA.0000000000003002","volume":"269","author":"J Fleshman","year":"2019","unstructured":"Fleshman J, Branda ME, Sargent DJ, Boller AM, George VV, Abbas MA, Peters WR Jr, Maun DC, Chang GJ, Herline A, Fichera A, Mutch MG, Wexner SD, Whiteford MH, Marks J, Birnbaum E, Margolin DA, Larson DW, Marcello PW, Posner MC, Read TE, Monson JRT, Wren SM, Pisters PWT, Nelson H (2019) Disease-free survival and local recurrence for laparoscopic resection compared with open resection of stage II to III rectal cancer: follow-up results of the ACOSOG Z6051 randomized controlled trial. Ann Surg 269(4):589\u2013595. https:\/\/doi.org\/10.1097\/SLA.0000000000003002","journal-title":"Ann Surg"},{"issue":"1","key":"13519_CR12","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-44247-8","volume":"13","author":"J Pi\u0105tkowski","year":"2023","unstructured":"Pi\u0105tkowski J, Jagielski M, Szeliga J, Nowak M, Jackowski M (2023) Transanal total mesorectal excision (TaTME) in rectal cancer treatment within an expert center. Sci Rep 13(1):17084. https:\/\/doi.org\/10.1038\/s41598-023-44247-8","journal-title":"Sci Rep"},{"key":"13519_CR13","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1186\/s12885-016-2428-5","volume":"16","author":"B Ma","year":"2016","unstructured":"Ma B, Gao P, Song Y, Zhang C, Zhang C, Wang L, Liu H, Wang Z (2016) Transanal total mesorectal excision (taTME) for rectal cancer: a systematic review and meta-analysis of oncological and perioperative outcomes compared with laparoscopic total mesorectal excision. BMC Cancer 16:380. https:\/\/doi.org\/10.1186\/s12885-016-2428-5","journal-title":"BMC Cancer"},{"issue":"1","key":"13519_CR14","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1007\/s00423-023-03147-1","volume":"408","author":"M Farooqi","year":"2023","unstructured":"Farooqi M, Hussain A, Ahmad A, Zaheer Z, Daniyal M, Tahir A, Fatima L, Maham R, Farooqui A, Khan A (2023) Impact of trans-anal versus laparoscopic total mesorectal excision on the surgical and pathologic outcomes of patients with rectal cancer: meta-analysis of randomized controlled trials. Langenbecks Arch Surg 408(1):413. https:\/\/doi.org\/10.1007\/s00423-023-03147-1","journal-title":"Langenbecks Arch Surg"},{"issue":"12","key":"13519_CR15","doi-asserted-by":"publisher","first-page":"9228","DOI":"10.1007\/s00464-023-10495-y","volume":"37","author":"X Yi","year":"2023","unstructured":"Yi X, Zhang X, Li Q, Ouyang J (2023) Comparing perioperative and oncological outcomes of transanal and laparoscopic total mesorectal excision for rectal cancer: a meta-analysis of randomized controlled trials and prospective studies. Surg Endosc 37(12):9228\u20139243. https:\/\/doi.org\/10.1007\/s00464-023-10495-y","journal-title":"Surg Endosc"},{"issue":"4","key":"13519_CR16","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1177\/1553350619839853","volume":"26","author":"L Li","year":"2019","unstructured":"Li L, Zhang W, Guo Y, Wang X, Yu H, Du B, Yang X, Luo Y (2019) Robotic versus laparoscopic rectal surgery for rectal cancer: a meta-analysis of 7 randomized controlled trials. Surg Innov 26(4):497\u2013504. https:\/\/doi.org\/10.1177\/1553350619839853","journal-title":"Surg Innov"},{"issue":"5","key":"13519_CR17","doi-asserted-by":"publisher","first-page":"1017","DOI":"10.1002\/ags3.70024","volume":"9","author":"M Hanaoka","year":"2025","unstructured":"Hanaoka M, Kagawa H, Igarashi A, Yoshihara H, Yamauchi S, Tokunaga M, Peng-Lin L, Shin M, Kinugasa Y (2025) Short- and long-term outcomes of open, laparoscopic, and robot-assisted surgery for rectal cancer. Ann Gastroenterol Surg 9(5):1017\u20131028. https:\/\/doi.org\/10.1002\/ags3.70024","journal-title":"Ann Gastroenterol Surg"},{"issue":"5","key":"13519_CR18","doi-asserted-by":"publisher","first-page":"761","DOI":"10.1002\/ags3.12824","volume":"8","author":"YY Park","year":"2024","unstructured":"Park YY, Kim NK (2024) Tailoring rectal cancer surgery: surgical approaches and anatomical insights during deep pelvic dissection for optimal outcomes in low-lying rectal cancer. Ann Gastroenterol Surg 8(5):761\u2013773. https:\/\/doi.org\/10.1002\/ags3.12824","journal-title":"Ann Gastroenterol Surg"},{"issue":"1","key":"13519_CR19","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-02438-1","volume":"11","author":"SH Song","year":"2021","unstructured":"Song SH, Park JS, Choi GS, Seo AN, Park SY, Kim HJ, Lee SM, Yoon G (2021) Impact of the distal resection margin on local recurrence after neoadjuvant chemoradiation and rectal excision for locally advanced rectal cancer. Sci Rep 11(1):22943. https:\/\/doi.org\/10.1038\/s41598-021-02438-1","journal-title":"Sci Rep"},{"issue":"1","key":"13519_CR20","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1002\/ags3.12724","volume":"8","author":"Y Homma","year":"2023","unstructured":"Homma Y, Mimura T, Koinuma K, Horie H, Lefor AK, Sata N (2023) Low anterior resection syndrome: incidence and association with quality of life. Ann Gastroenterol Surg 8(1):114\u2013123. https:\/\/doi.org\/10.1002\/ags3.12724","journal-title":"Ann Gastroenterol Surg"},{"issue":"5","key":"13519_CR21","doi-asserted-by":"publisher","first-page":"427","DOI":"10.3393\/ac.2022.00227.0032","volume":"39","author":"SL Lim","year":"2023","unstructured":"Lim SL, Wan Zain WZ, Zahari Z, Zakaria AD, Hashim MNM, Wong MP, Zakaria Z, Ramely R, Sidek ASM (2023) Risk factors associated with low anterior resection syndrome: a cross-sectional study. Ann Coloproctol 39(5):427\u2013434. https:\/\/doi.org\/10.3393\/ac.2022.00227.0032","journal-title":"Ann Coloproctol"},{"key":"13519_CR22","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1016\/j.ijsu.2018.06.031","volume":"56","author":"AD Croese","year":"2018","unstructured":"Croese AD, Lonie JM, Trollope AF, Vangaveti VN, Ho YH (2018) A meta-analysis of the prevalence of low anterior resection syndrome and systematic review of risk factors. Int J Surg 56:234\u2013241. https:\/\/doi.org\/10.1016\/j.ijsu.2018.06.031","journal-title":"Int J Surg"},{"issue":"4","key":"13519_CR23","doi-asserted-by":"publisher","first-page":"e46","DOI":"10.1016\/j.amjsurg.2008.07.060","volume":"197","author":"K Funahashi","year":"2009","unstructured":"Funahashi K, Koike J, Teramoto T, Saito N, Shiokawa H, Kurihara A, Kaneko T, Shirasaka K, Kaneko H (2009) Transanal rectal dissection: a procedure to assist achievement of laparoscopic total mesorectal excision for bulky tumor in the narrow pelvis. Am J Surg 197(4):e46\u2013e50. https:\/\/doi.org\/10.1016\/j.amjsurg.2008.07.060","journal-title":"Am J Surg"},{"key":"13519_CR24","doi-asserted-by":"publisher","DOI":"10.1016\/j.suronc.2021.101695","volume":"43","author":"MLW Rutgers","year":"2022","unstructured":"Rutgers MLW, Bemelman WA, Khan JS, Hompes R (2022) The role of transanal total mesorectal excision. Surg Oncol 43:101695. https:\/\/doi.org\/10.1016\/j.suronc.2021.101695","journal-title":"Surg Oncol"},{"issue":"4","key":"13519_CR25","doi-asserted-by":"publisher","first-page":"225","DOI":"10.23922\/jarc.2023-027","volume":"7","author":"D Kitaguchi","year":"2023","unstructured":"Kitaguchi D, Hasegawa H, Ando K, Ikeda K, Tsukada Y, Nishizawa Y, Ito M (2023) Transanal total mesorectal excision for rectal cancer: toward standardization of the surgical technique. J Anus Rectum Colon 7(4):225\u2013231. https:\/\/doi.org\/10.23922\/jarc.2023-027","journal-title":"J Anus Rectum Colon"},{"issue":"8","key":"13519_CR26","doi-asserted-by":"publisher","first-page":"1791","DOI":"10.1007\/s11605-022-05342-9","volume":"26","author":"H Yan","year":"2022","unstructured":"Yan H, Wang PY, Wu YC, Liu YC (2022) Is a distal resection margin of \u2264 1 cm safe in patients with intermediate- to low-lying rectal cancer? A systematic review and meta-analysis. J Gastrointest Surg 26(8):1791\u20131803. https:\/\/doi.org\/10.1007\/s11605-022-05342-9","journal-title":"J Gastrointest Surg"},{"issue":"9","key":"13519_CR27","doi-asserted-by":"publisher","DOI":"10.1093\/bjs\/znaf190","volume":"112","author":"I Prata","year":"2025","unstructured":"Prata I, Tanaka MD, Glimelius B, Nagtegaal ID, Beets-Tan RGH, Blomqvist LK, Couwenberg AM, van Etten B, Hospers GAP, Meershoek-Klein Kranenbarg E, Peeters KCMJ, Putter H, Roodvoets AGH, van de Velde CJH, Nilsson PJ, Marijnen CAM (2025) Factors influencing locoregional recurrence rates in locally advanced rectal cancer after total neoadjuvant treatment versus chemoradiotherapy in the RAPIDO trial. Br J Surg 112(9):znaf190. https:\/\/doi.org\/10.1093\/bjs\/znaf190","journal-title":"Br J Surg"},{"issue":"4","key":"13519_CR28","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1007\/s13193-017-0637-2","volume":"8","author":"AS Kapali","year":"2017","unstructured":"Kapali AS, Chandramohan K, Jayasudha AV (2017) A prospective study of distal microscopic spread in rectal cancer after neoadjuvant chemoradiation in pinned and unpinned specimen. Indian J Surg Oncol 8(4):469\u2013473. https:\/\/doi.org\/10.1007\/s13193-017-0637-2","journal-title":"Indian J Surg Oncol"},{"issue":"7","key":"13519_CR29","doi-asserted-by":"publisher","first-page":"700","DOI":"10.1177\/1066896919854159","volume":"27","author":"D Lam","year":"2019","unstructured":"Lam D, Kaneko Y, Scarlett A, D\u2019Souza B, Norris R, Woods R (2019) The effect of formalin fixation on resection margins in colorectal cancer. Int J Surg Pathol 27(7):700\u2013705. https:\/\/doi.org\/10.1177\/1066896919854159","journal-title":"Int J Surg Pathol"},{"issue":"3","key":"13519_CR30","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1093\/ajcp\/111.3.349","volume":"111","author":"NS Goldstein","year":"1999","unstructured":"Goldstein NS, Soman A, Sacksner J (1999) Disparate surgical margin lengths of colorectal resection specimens between in vivo and in vitro measurements. The effects of surgical resection and formalin fixation on organ shrinkage. Am J Clin Pathol 111(3):349\u2013351. https:\/\/doi.org\/10.1093\/ajcp\/111.3.349","journal-title":"Am J Clin Pathol"}],"container-title":["Surgical Endoscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00464-026-13519-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00464-026-13519-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00464-026-13519-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T12:24:06Z","timestamp":1791980646000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00464-026-13519-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,12]]},"references-count":30,"alternative-id":["13519"],"URL":"https:\/\/doi.org\/10.1007\/s00464-026-13519-5","relation":{},"ISSN":["0930-2794","1432-2218"],"issn-type":[{"value":"0930-2794","type":"print"},{"value":"1432-2218","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,12]]},"assertion":[{"value":"1 June 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 October 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 October 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Takuya Shiraishi, Mizuki Endo, Naoya Ozawa, Chika Komine, Takuhisa Okada, Akiharu Kimura, Akihiko Sano, Makoto Sakai, Ken Shirabe, and Hiroshi Saeki have no conflicts of interest or financial ties to disclose.","order":1,"name":"Ethics","label":"Disclosures","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The research protocol was approved by a suitably constituted Ethics Committee of the Gunma University Hospital (Approval Number: HS2022-042) and was conducted in accordance with the principles of the Declaration of Helsinki.","order":2,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The requirement for written informed consent was waived because of the retrospective nature of the study. Information regarding the study was disclosed on the institutional website, and patients were provided with the opportunity to opt out.","order":3,"name":"Ethics","label":"Informed consent","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":4,"name":"Ethics","label":"Registry and the registration number of the study","group":{"name":"EthicsHeading","label":"Declarations"}}]}}