To investigate the efficacy of laparoscopic internal and external resection of the sphincter (ISR) in the treatment of low rectal cancer and its influence on anal function.

Seventy-eight patients with low rectal cancer in Beijing Fengtai Integrated Traditional Chinese Medicine and Western Medicine Hospital were retrospectively analyzed, including forty-two cases of laparoscopic ISR (observation group) and thirty-six cases of open ISR (control group). The operation related indexes, oncological efficacy, anal function classification, postoperative complication rate and postoperative survival rate were compared between the two groups.

There was no significant difference in the operation time between the two groups (t=1.208, P>0.05). The intraoperative blood loss in the observation group was significantly lower than that in the control group, and the ventilation time, fasting time and length of stay were significantly shorter than those in the control group (P<0.05). The number of lymph nodes detected, the size of tumor, the length of distal margin of tumor, the degree of tissue differentiation and TNM staging were not significantly different between the two groups (P>0.05). Two Wexner score, frequency of defecation, urgency of defecation, bowel control reduce, Kirwan anal function grading were not statistically significant between the two groups (P>0.05). The incidence of postoperative complications in the observation group was significantly lower than that in the control group (χ²=5.520, P<0.05). There was no significant difference in the 3 year survival rate between the two groups (χ²=1.065, P>0.05).

The effect of laparoscopic ISR and open ISR on the efficacy of oncology, survival rate and anorectal function in patients with low rectal cancer is comparable, but the former is less traumatic, reduces intraoperative bleeding, promotes rehabilitation, reduces complications, and has more clinical application value.