In patients receiving proctectomy for nonmetastatic rectal cancer, the researchers sought to investigate the relationship between neoadjuvant treatment methods and perioperative complications. Between 2010 and 2018, patients receiving total mesorectal excision for nonmetastatic rectal cancer after SC-TNT or CRT were included in the single-center retrospective cohort research. The researchers conducted a univariate study of severe POM and several secondary outcomes, including total POM, intraoperative complications, and resection margins. Severe POM was also subjected to logistic regression. About 156 (38%) of the 415 patients included in the study received SC-TNT, while 259 (62%) underwent CRT. Patients with larger tumours (69.9% vs 47.5%, P=0.0001) and node-positive disease (76.9% vs 62.6%, P=0.004) were more likely to get SC-TNT. Between cohorts, there was no change in the incidence of severe POM (9.6% SC-TNT vs 12.0% CRT, P=0.46) or overall POM (39.7% SC-TNT vs 37.5% CRT, P=0.64). In multivariate analysis, the neoadjuvant regimen was not related with a difference in severe POM (odds ratio 0.42, 95% confidence interval 0.04–4.70, P=0.48). There was no link between the neoadjuvant regimen and any secondary outcomes. Researchers discovered no significant connection between POM and SC-TNT and proctectomy in rectal cancer patients treated with SC-TNT and proctectomy compared to patients treated with CRT. Compared to CRT, SC-TNT does not significantly enhance the risk of POM.