To investigate the effect of laparoscopic total mesorectal excision (TME) combined with intersphincteric resection (ISR) in the treatment of ultra-low rectal cancer.

Forty-two patients with ultra-low rectal cancer were given laparoscopic TME combined with ISR from January 2009 to June 2012. According the principle of TME, firstly the resection of the rectum was completed, and then the operation was carried out through the internal anal sphincter. The clinical data, postoperative complications and follow-up result were collected for all patients.

All operations were successful, with no one being transferred to open procedure or laparoscopic Mile's. Among them, 13 were given preventive ileostomy. Anastomotic leakage occurred in 2 patients and was cured by conservative therapy; all patients were satisfied with the postoperative anal sphincter function. There was no death during the operation. During the 9-40-month follow up, one patient was rehospitalized for further treatment because of the occurrence of liver metastasis cancer after fifteenth months.

It is feasible for the appropriate patients with ultra-low rectal cancer, diagnosed in early and middle stage and without cancer invading the external sphincter, to undergo laparoscopic TME combined with ISR. It raises the possibility of anal preservation, improve their postoperative quality of life and decreases incidence of local tumor recurrence.