Objectives  To evaluate the safety and feasibility of ultra-low anastomosis for anal preservation in laparoscopic rectal cancer surgery.

  Methods  The clinical data of 54 patients with low rectal cancer admitted to The Affiliated Hospital of Southwest Medical University from July 2014 to June 2017 were retrospectively analyzed. The short-term effect and complications were analyzed.

  Results  All patients underwent successful operations; conversion to laparotomy or death was not observed in any of the patients. The mean operative time was (165 ±31) minutes, and the intraoperative bleeding volume was (12 ±5) mL. There was no prophylactic ileostomy in all patients. Postoperative anastomotic bleeding and anastomotic leakage occurred in 2 and 3 cases, respectively; these complications were managed with conservative treatment. Postoperative urination and sexual functions of the patients remained good, and most patients were satisfied with their anal function 1 year post-operation. No local recurrences or deaths were noted after follow-up for more than 2 years. However, liver metastases were detected in 3 patients 1 year post-surgery.

  Conclusions  Laparoscopic transabdominal ultra-low anastomosis for rectal cancer has a good short-term effect; however, the long-term effect remains to be evaluated.