The rectum is about 12-15cm long and most of it is located in the pelvic cavity and narrow space in front of the sacrum, so it is difficult to operate for rectal cancer, and the space for low rectal cancer is even smaller, and it involves the question of whether the function of rectal-anal sphincter can be preserved, so the choice of surgical treatment plan for rectal cancer is closely related to the location of the long cancer lesion. If the cancer lesion is more than 7cm away from the anus, transabdominal proctocolectomy can be performed, i.e., sigmoid colon and low rectum including the cancer lesion can be removed, and then a one-stage end-to-end anastomosis between the descending colon and the cut end of the rectum can be performed to restore the continuity of the intestine at one time, and it is important to preserve the defecation control function of the anal sphincter, which has a good effect. ＜If the cancer is less than 7 cm away from the anus, a combined transabdominal perineal radical rectal surgery (Miles surgery) is required, which means that in addition to the removal of the sigmoid colon, the entire rectum, rectal mesentery, scirorectal space tissue, anal sphincter and anus are completely removed, the anal incision is closed, a permanent fistula (artificial anus) is made in the proximal colon in the left lower abdomen, and an artificial anal pouch is attached to collect the stool. The Hartmann procedure, on the other hand, is a kind of palliative surgery, which is commonly known as a simple surgery that does not allow for radical resection for some reason and does not achieve the goal of cure. The procedure involves transabdominal resection of rectal cancer, closure of the distal rectal stump, and proximal colostomy. As shown in the figure. The Hartmann procedure is suitable for: 1. patients with poor general condition and multiple diseases (such as hypertension, diabetes, poor cardiopulmonary function, etc.) who cannot tolerate combined transabdominal-perineal radical resection of rectal cancer; 2. patients with acute bowel obstruction who are considered to have non-healing first-stage anastomosis after resection and are not suitable for Dixon surgery (transabdominal proctocolectomy, low anterior rectal resection); 3. elderly Patients. After Hartmann’s surgery, in order to improve patients’ quality of life and relieve psychological stress, in principle, “fistula back” surgery should be performed after 3-6 months, which means removing the fistula, suturing the fistula wound, opening and partially removing the original closed distal rectum, and then anastomosing the proximal colon with the rectal stump, so as to restore the original The fistula will be removed, the incision will be sutured, and the distal rectum will be partially removed. If the patient is too old to tolerate fistula surgery, if the patient is used to fistula and does not require fistula, or if the patient is afraid of fistula surgery, fistula can be avoided.