Transanal Total Mesorectal Excision Versus Laparoscopic TME for Rectal Cancer

Inclusion Criteria: * Biopsy-proven adenocarcinoma of the rectum * Eligible to undergo conventional laparoscopic low anterior resection or transanal hybrid-laparoscopic low anterior resection with or without a temporary diverting stoma * Node negative (N0), T1 (high risk features), T2 and T3 rectal cancer on pelvic MRI * Closest distance between tumor edge and mesorectal fascia 5mm or more based on pelvic MRI * Rectal cancer located 3-10 cm from the anal verge Exclusion Criteria: * Metastasis * Obstructing rectal cancer * Synchronous colon cancer * T4 rectal cancer not treated preoperatively with full-course chemoradiation * Pregnant or breast-feeding * Receiving any other study agents * Fecal incontinence * History of prior colorectal cancer * History of inflammatory bowel disease * History of pelvic radiation * BMI \> 40 * Large uterine fibroids * Uncontrolled intercurrent illness