Besides the distance of the tumor from the anal verge, it is also affected by the following conditions: 1. gender: because the male pelvis is narrower than the female pelvis, the space available for surgical operation is more limited and the surgical operation is more difficult, so it is more likely for male patients with low rectal cancer to undergo bowel diversion. 2. Weight and height index (BMI): Obesity can also affect the successful completion of anal preservation surgery. In some reports, an increase in BMI will lead to an increase in the chance of APR. Only 37.2% of patients with normal weight failed to preserve the anus, while 46.7% of obese patients failed to preserve the anus. 3. Surgeon’s surgical technique: Different surgeons have a significant impact on the success rate of anal preservation due to their different surgical proficiency and concepts of dealing with the problem. The success rate of anal preservation is higher for experienced surgeons and specialists. 4. Functional status of the patient’s local tissues: Poor functional status of local tissues often leads to anastomotic fistula after resection of low and middle rectal cancer, thus affecting the successful completion of anal preservation surgery. It mainly includes factors such as tension of anastomotic site, blood flow and whether radiotherapy is given before surgery. 5.Patients’ systemic status: When patients with low rectal cancer have intestinal obstruction, intestinal perforation, peritonitis and systemic infection, often the anastomosis cannot be completed in one phase, and even if the anastomosis is completed, the incidence of postoperative anastomotic fistula is higher, which leads to failure of anal preservation surgery. Therefore, the poor general condition of patients may also affect the success of anus-preserving surgery for low rectal cancer. In conclusion, anal preservation surgery for low rectal cancer should be individualized according to the patient and there is no completely uniform standard.