肛提肌以上脓肿是肛肠科少见且疑难的疾病，发病急且病情重，手术是重要的治疗方式，主要采用切开挂线术。因这类脓肿位置深、腔隙大，术后仍然会不同程度损伤肛周肌肉，破坏肛门功能和外形，遗留后遗症。中国中医科学院广安门医院肛肠科李华山教授根据30余年的丰富临床经验，结合微创外科理念，创造性地提出直肠内挂线术这一新颖术式，不仅提高了该类脓肿根治率，还极大程度保护了肛门功能及肛周形态的完整性。本文详细总结了直肠内挂线术治疗肛提肌以上脓肿的临床经验，以期在临床推广这种术式。

The abscess above the levator ani muscle is a rare and difficult disease of Anorectal Department, which is acute and serious, the operation is an important treatment way, basically use incision to hang a line operation. Because this kind of abscess position is deep, lacunae big, through this surgical procedure still can injure perianal muscle of different degrees after the operation, destroy anus function and appearance, leave sequela. Professor Li Huashan creatively proposed the novel operation method of thread-drawing inside rectum based on his rich clinical experience of more than 30 years and the concept of minimally invasive surgery, which not only improved the radical treatment rate of this kind of abscess but also greatly protected the integrity of anal function and perianal morphology. This paper summarized clinical experience in the treatment of abscess above the levator ani muscle by rectum hanging in detail, and in order to promote this surgical method in clinical practice.