The main reason for this is that it is a very important tool in the treatment of rectal cancer, and in principle, radical rectal cancer surgery can be divided into anal diversion surgery, which removes the anus, and resection surgery, which preserves the anus. Once a patient has rectal cancer, the main concern of the patient and his family is whether the anus can be preserved and whether it should be “rerouted”, in addition to whether it can be completely cured by surgery. This is because it is related to the patient’s quality of life after surgery and the impact on social activities and work. Multiple factors determine whether to preserve the anus or not. The choice of rectal cancer surgery and whether the anus can be preserved depends on many factors. First, the location of the tumor in the rectum; second, the smallness of the tumor and the early and late stage of the disease; third, the surgeon’s surgical skills and clinical experience as well as his mastery of various surgical methods; fourth, the patient’s body fatness and other conditions affecting the surgical operation. The location of the tumor is the key to the selection of the surgical procedure The length of the rectum is generally 12-15 cm, which can be roughly divided into three segments: upper, middle and lower. Upper segment rectal cancer generally refers to rectal cancer that is more than 10 cm away from the anus, and in principle, there is no problem to do rectal cancer resection surgery that preserves the anus. Whether in terms of surgical techniques or the thoroughness of tumor removal, gastrointestinal surgeons with formal training and certain experience can perform more standardized anus-preserving resection. Mid-stage rectal cancer tumor is located in the middle part of the rectum, whether the anus can be preserved or not needs comprehensive analysis and judgment. What is the size of the tumor? To what extent does it infiltrate the tissues around the rectum? How fat and thin is the patient and how wide and narrow is the pelvis? If these factors are favorable, that is, the tumor is not large, the patient is thin and the pelvis is wide, then the resection surgery can be done to preserve the anus and cure the tumor at the same time. If the tumor in the middle rectum is very large and infiltrates the surrounding tissues severely, the anus-preserving surgery should be abandoned to ensure the thoroughness of tumor removal. Lower rectal cancer generally refers to tumors within 5 cm from the anal verge, and in principle, radical surgery to remove the anus should be chosen. Most patients with rectal cancer are already in the middle and late stages of the disease when they visit the doctor, and the tumor is usually very large in size, so only radical rerouting surgery can achieve the purpose of complete removal of the tumor. However, if the tumor is small and does not break out of the rectal mucosa, a procedure called low level resection and anal preservation can be chosen to preserve the anus. However, there are many debates about this procedure and many related issues are still debatable, so it should be limited to large hospitals with conditions and specialists with rich clinical experience in gastrointestinal surgery for selection, and should not be popularized in general hospitals. Life is most precious No matter what, surgeons and rectal cancer patients should analyze the condition objectively, scientifically and comprehensively according to the actual situation, and choose the surgery method correctly and reasonably. People generally believe that it is lucky to be able to preserve the anus, otherwise it is unfortunate. However, it is the greatest misfortune of rectal cancer patients if surgeons do not adhere to the principle, and reluctantly perform anus-preserving surgery for patients who do not meet the conditions, resulting in unnecessary tumor recurrence and metastasis, and delaying the timing of radical surgery. What general surgeons and patients can agree is that protecting life safety is the first priority, and preserving the anus is the second. Gastrointestinal surgeons should tell patients with rectal cancer that after radical surgery, they can eventually live, work, and participate in social activities as ordinary people with the care and training of a “false anus”. Foreign research data show that there is no difference in quality of life between patients with diversion and patients with anal preservation. Therefore, it is very important for patients with diversion to maintain a healthy psychological state.