Detering R, et al. - In this nationwide study, the initial transanal total mesorectal excision (TaTME) experience in the Netherlands was evaluated for the first time, by comparing outcomes with conventional laparoscopic TME (lapTME). From the nationwide and mandatory Dutch ColoRectal Audit (DCRA), they selected 3,777 patients with rectal cancer who underwent curative TaTME, n = 416 or lapTME, n = 3361, between January 2015 and December 2017. After 1:1 matching, researchers included 396 patients in each group, with comparable baseline characteristics. After TaTME and lapTME, circumferential resection margin involvement was 4.3% and 4.0%, respectively. A significantly lower conversion rate in TaTME was observed. No significant differences in anastomotic leak rate were noted. The current data on adoption of TaTME thereby demonstrate the acceptable short-term outcomes when compared with the well-established lapTME.