**7. Conclusion**

Transanal excision of rectal tumors is a valid, safe, and reproducible alternative to conventional anterior resection for the treatment of early rectal cancer, showing comparable oncological results with the advantages of an organ-sparing surgical strategy favorably impacting on overall patients' QoL as compared with low anterior resection. Encouraging results have been obtained also in the treatment of locally advanced tumors in association with n-CRT, although randomized controlled trials with long-term follow-up and shared protocols are still needed to definitely asses the role of TEM and TAMIS in non-early rectal cancer. Globally, the morbidity rate of both techniques is lower than after anterior resection, and their main complications including postoperative bleeding, suture line dehiscence, and urinary complications can be safely managed in most cases without conventional surgical revision or fecal diversion. The functional outcomes are also satisfactory, with mainly transient disturbance of anorectal physiology and progressive functional recovery. In conclusion, transanal excision techniques must be rightfully included in the armamentarium of the technical skills of any colorectal surgeon for the multimodality treatment of rectal cancer.
