Local excision of rectal lesions includes: transabdominal local excision of rectal lesions, transanal local excision, and trans-posterior local excision. Despite the many advantages of trans-posterior local excision, most general surgeons are still not very familiar with this route of surgery, and they often believe that fecal fistula, anal dysfunction, and incisional infections occur frequently after this route of surgery; in fact, the high incidence of these complications is reported before proper bowel preparation, prophylactic application of antibiotics, and adequate drainage. Indications for resection of rectal lesions via the posterior route: nowadays, the posterior route is mainly used to resect benign rectal lesions, but also for small rectal cancers (mainly early rectal cancers), and basically not for progressive rectal cancers, and occasionally for progressive rectal cancers (when performing abdominal sacral proctocolectomy in combination with abdominal operations to obtain a wide field of view and resection of the lesion). Specific indications: It can be used to selectively treat benign, precancerous and malignant lesions of the rectum located below the peritoneal reflex and with the lower edge of the lesion 6-9 cm from the anal verge. Benign lesions such as rectal polyps, rectal stenosis, rectovaginal fistula, rectal hemangioma, rectal endometriosis nodes, etc.; early-stage rectal cancers that do not require lymph node dissection; early and mid-stage rectal cancers that cannot tolerate prolonged transabdominal rectal resection due to advanced age, frailty and other serious diseases such as cardiac, pulmonary, hepatic and renal insufficiency; local resection that can be supplemented with radiotherapy and chemotherapy, as well as some advanced rectal cancers that have not yet locally invaded For those who have advanced rectal cancer that has not yet invaded the adjacent structures or organs of the rectum, palliative local resection is performed to relieve bleeding or delay the occurrence of obstruction. There are no important large vessels in the field of this procedure, so as long as the level of access is correct, the operation is safe. In addition, although this procedure is sometimes associated with complications such as incisional infection and rectal fistula, these complications are safe after surgery because they occur outside the peritoneum and do not cause widespread peritonitis. The greatest advantage of this procedure is that it avoids the increased surgical trauma caused by opening the abdomen.