On the issue of whether to do prophylactic stoma after anus-preserving surgery for low rectal cancer, there have been two kinds of opinions for and against it for many years. I used to be one of them, and now I realize that many of my perceptions were one-sided at the beginning. First of all, can prophylactic stoma reduce the incidence of anastomotic leakage? Many doctors think that it can’t, but it can only play a role in diverting the flow once it leaks. Most anastomotic leaks occur only after the patient resumes defecation, because the anastomosis is not under tension due to the continuous passage of stool through the anastomosis. Especially in the case of low rectal cancer, the anus is not yet free to retract and release, and at this time the stool accumulates at the anastomosis, and the infection factor and pressure on the anastomosis are the causes of leakage. Therefore, prophylactic stoma is not only a diversion problem, but also has the function of reducing anastomotic leakage. Secondly, is a prophylactic stoma made only to prevent leaks? This problem has been explained by Prof. Chuangangang Fu, especially in ultra-low rectal cancer, not only is there a high risk of anastomotic leakage, but also due to the low free rectum of ultra-low anus-preserving surgery, the damage to the pelvic nerve and muscle, and the ultra-low anastomosis, most of the patients’ recent postoperative anal function is not very satisfactory, and most of them have poor stool control, edema, spasm, pain, etc. At this time, the first-stage anastomosis immediately If the anastomosis is used immediately, not only is the result unsatisfactory, but the patient’s quality of life is also very poor and even painful. At this time, the use of this ultra-low anastomosis, even if there is no leakage, there will be part of the stool incontinence, perianal eczema itching pain, and even some pain, far better than the first stoma through three months and then returned to the better, then the patient anastomosis healed well inflammation subsided, anal function exercise recovery is better, at this time to start its function is not directly used at the beginning of so painful, so that ultra-low prevention stoma not only is not only to prevent leakage, but also for the patient’s survival quality. Thirdly, the current tense doctor-patient relationship has also prompted doctors to accept more and more prophylactic stomas. As patients are becoming more and more demanding, it is difficult to accept not only leakage, but also recent anal dysfunction, etc., and many anastomoses have stenosis after leakage has healed again, causing defecation disorders, etc. It is even less acceptable ….. Then prophylactic stoma is not unprotected. The Department of Anorectal Surgery of Changhai Hospital stipulates that prophylactic stoma should be routinely done for anal preservation surgery for low rectal cancer, from this perspective, there is no question of whether to do prophylactic stoma or not, and there is no question of whether it should be done or not, only the question of which aspect the operator is considering. In short, whether to make a stoma or not, the reasons are complex and cannot be generalized, the operator can grasp it by himself according to the specific situation, although it is impossible for every unit to stipulate that preventive stoma must be done routinely like Changhai Hospital, but it is even more undesirable not to do it routinely.