With the development of laparoscopic instruments and the continuous progress of surgeons’ operating techniques, laparoscopic colorectal cancer surgery has gradually manifested the advantages of less surgical trauma and faster postoperative recovery, and has been widely used in clinical practice, and its safety feasibility and tumor radicality have been recognized. For low-level rectal cancer and anal canal cancer without preserving the anus, abdominal perineal resection (Miles surgery) is still the main surgical method. The abdominal operation part of laparoscopic perineal resection has the advantages of clear vision, clear anatomical level, less bleeding and smaller incision compared with open surgery, while the operation of perineal part is exactly the same as open surgery, usually in the truncated position, and due to the position, there is a dead angle in the field of vision when exposing the anterior rectal wall, and in general, the posterior wall and both walls of the rectum of the anal canal need to be freed first, and then the specimen is pulled out and freed after meeting with the abdomen The anterior rectal wall, on the one hand, is prone to bleeding due to poor exposure, and it is difficult to stop bleeding due to poor visualization, on the other hand, it is easier to accidentally injure the prostate or the posterior vaginal wall. Therefore, the perineal operation of Miles surgery in the traditional lithotomy position still has some limitations. We have improved the operation method of laparoscopic Miles surgery by first performing perineal resection in the folding position, and then adjusting it to a flat position for laparoscopic abdominal operation. The perineal operation was performed completely under direct vision. During the freeing of the anterior rectal wall, it was not easy to damage the prostate or the posterior vaginal wall because of clear exposure, and hemostasis was completely under direct vision with less bleeding. When the abdominal operation is performed after adjusting the position, the posterior wall of the rectum is first released through the presacral space to meet with the perineum, and then both walls of the rectum are released, and the anorectal canal that has been released is pulled in the direction of the epigastrium and then the anterior wall of the rectum is continued to be released. During the laparoscopic operation, since the anterior rectal wall was released last, the anatomical structure was clearly displayed, which was also less likely to cause accidental injury. However, the amount of perineal bleeding was significantly reduced, postoperative perineal complications were less frequent, pelvic floor exudation was significantly reduced, the time to remove the abdominal drainage tube was significantly earlier than that of the lithotomy group, and the patient’s The patients’ mental status was better than that of the lithotomy group. Therefore, laparoscopic combined folding-incision rectal cancer radical abdominoperineal surgery has certain advantages over traditional lithotomy. The traditional Miles procedure is followed by laparoscopic exploration and then laparotomy and perineal operation, and once the exploration reveals extensive metastasis in the abdominal cavity or unresectable tumor, the operation can be aborted in time. Therefore, in order to avoid the situation that no surgical resection is indicated after perineal resection and laparotomy, the accuracy of preoperative clinical staging is very important. For cases with limited lesions, such as local resection followed by extended radical surgery and postoperative local recurrence, folding surgery is especially suitable. For patients with larger and more extensive tumors, neoadjuvant chemotherapy and radiotherapy should be followed by abdominal CT, and folding Miles surgery should be considered after resectability. A total of 3 patients in both groups were treated with neoadjuvant chemotherapy, and the tumors shrank significantly after treatment. Therefore, we believe that laparoscopic combined folded-incision radical abdominoperineal surgery for rectal cancer has certain advantages compared with traditional lithotomy with less perineal bleeding and postoperative exudation, but we need to select suitable cases for such surgery.