To investigate the application value of transanal assistance in laparoscopic transabdominal intersphincteric resection (ISR) sphincter-preserving surgery for low rectal cancer.

A retrospective analysis of clinical data from 37 patients with cT1~T2 low rectal cancer who underwent transanal assistance in laparoscopic transabdominal ISR at He’nan Provincial People’s Hospital between February 2023 and February 2025. During surgery, the assistant used the self-made anal lifter and anal pusher to assist the primary surgeon in dissecting the distal rectum to achieve subtotal or total ISR, reconstructing the digestive tract, or reinforcing the anastomosis. Baseline characteristics, postoperative pathology, postoperative complications, and tumor recurrence or metastasis during follow-up were collected and analyzed.

All 37 patients successfully underwent ISR sphincter-preserving surgery without prophylactic stoma creation, conversion to open surgery, or change in surgical approach. The mean operative time was (198.38±30.48) min, with a median intraoperative blood loss of 100 (50~250) mL. All patients achieved R0 resection, with a mean number of lymph nodes removed of (19.51±3.62). The mean postoperative hospital stay was (10.32±2.31) days. No tumor cells were detected in the cytological examination of the peritoneal lavage fluid. No anastomotic leaks or perioperative deaths occurred. All patients underwent postoperative follow-up with a median duration of 10 (6~18) months. No tumor recurrence or metastasis was observed during follow-up.

The application of transanal assistance in laparoscopic transabdominal ISR sphincter-preserving surgery for low rectal cancer is safe and feasible.