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目的:总结和分析经肛全直肠系膜切除术（taTME）治疗中低位直肠癌的术后短期并发症。方法:采用描述性病例系列研究方法，回顾性收集首都医科大学附属北京友谊医院普通外科2016年11月至2021年4月期间，连续性接受taTME治疗的83例中低位直肠癌患者病例资料，男58例（69.9%）；年龄（61.4±11.8）岁；其中低位直肠癌42例（50.6%），中位直肠癌41例（49.4%）。术后短期并发症的定义为术后30 d内发生的并发症；Clavien-Dindo评分标准进行并发症分级同时将本组前40例与后43例患者的术后短期并发症发生率进行比较，以了解度过taTME学习曲线前后并发症发生率的差异。结果:81例完成腹腔镜辅助taTME手术，中转开腹2例（2.5%）。有78例（94.0%）完成吻合，另外5例（6.0%）行永久性造口。经腹+经肛总手术时长（246.9±85.0） min，中位术中出血量100（n IQR：100） ml。75例（96.2%，75/78）行预防性造口，其中74例行预防性回肠造口，1例行预防性横结肠造口；3例未行造口。术后30 d内并发症发生率为38.6%（32/83），出院后并发症发生率为8.4%（7/83）。轻度并发症占比31.3%（26/83），重度并发症占比7.2%（6/83），没有患者在术后30 d内死亡。吻合口漏发生率15.4%（12/78）。8例（9.6%）患者出院后因并发症再次入院。术后中位住院时间7（n IQR：3） d。所有的轻度（Ⅰ+Ⅱ级）并发症患者均予以常规保守对症治疗。1例C级吻合口漏出现感染中毒性休克、多器官功能障碍，转入重症监护室并接受二次手术；2例Ⅲa级麻痹性肠梗阻患者行内镜下肠梗阻导管置入治疗；3例出现Ⅲ级及以上呼吸系统并发症，其中1例出现胸腔积液行B超引导下穿刺，2例呼吸衰竭的患者经抗感染及对症处理等治疗，好转出院；1例Ⅲb级泌尿系感染者急诊行输尿管支架植入。本组前40例患者术后出现并发症20例（50.0%），后43例术后并发症发生率显著降低（12例，27.9%），与前40例相比，差异有统计学意义（χn 2=4.270，n P=0.039）。n 结论:taTME用于治疗中低位直肠癌具有可接受的并发症发生率，手术经验的积累在降低术后并发症的发生方面发挥着重要的作用。“,”Objective:To summarize short-term postoperative complications of transanal total mesorectal excision (taTME) in the treatment of middle-low rectal cancer.Methods:A descriptive case series of cases was constructed. Clinical data of consecutive 83 patients with mid-low rectal cancer who received taTME treatment from November 2016 to April 2021 at Department of General Surgery of Beijing Friendship Hospital, Capital Medical University were collected. Among 83 patients, 58 (69.9%) were males, with a mean age of (61.4±11.8) years; 42 (50.6%) were low rectal cancer, 41 (49.4%) were middle rectal cancer. Short-term postoperative complication was defined as complication occurring within 30 days after operation. The complication was graded according to the Clavien-Dindo classification. At the same time, the morbidity of short-term postoperative complication in the first 40 patients and that in the last 43 patients were compared to understand the differences before and after passing the taTME learning curve.Results:Two patients (2.5%) were converted to laparotomy ; 78 (94.0%) completed anastomosis.While 5 (6.0%) underwent permanent stoma. The total operation time of transabdominal+ transanal procedure was (246.9±85.0) minutes, and the median intraoperative blood loss was 100 (n IQR: 100) ml. Seventy-five cases (75 /78, 96.2%) underwent defunctioning stoma, including 74 cases of diverting ileostomy, 1 case of diverting transverse colostomy and 3 cases without stoma. The morbidity of complication within 30 days after operation was 38.6% (32/83), and the morbidity of complication after discharge was 8.4% (7/83). Minor complications accounted for 31.3% (26/83) and major complications accounted for 7.2% (6/83). No patient died within 30 days after operation. The incidence of anastomotic leakage was 15.4% (12/78). Eight patients (9.6%) were hospitalized again due to complications after discharge. The median postoperative hospital stay was 7 (n IQR: 3) days. All the patients with minor (I-II) complications received conservative treatment. One patient with grade C anastomotic leakage was transferred to intensive care unit and received a second operation due to sepsis and multiple organ dysfunction. Two patients with paralytic ileus (Clavien-Dindo IIIa) underwent endoscopic ileus catheter placement. There were 3 patients with Clavien-Dindo III or above respiratory complications, including 1 patient with pleural effusion and ultrasound-guided puncture, 2 patients with respiratory failure who were improved and discharged after anti-infection and symptomatic treatment. One patient underwent emergency ureteral stent implantation due to urinary infection (Clavien-Dindo IIIb). The morbidity of postoperative complication in the first 40 cases was 50.0% (20/40), and that in the latter 43 cases decreased significantly (27.9%, 12/43), whose difference was statistically significant (χn 2=4.270, n P=0.039).n Conclusions:The procedure of taTME has an acceptable morbidity of short-term postoperative complication in the treatment of mid-low rectal cancer. The accumulation of surgical experience plays an important role in reducing the morbidity of postoperative complication.