1, the timing of low anal preservation It is well known that the recurrence rate of low anal preservation surgery is relatively high, but the success rate will be improved a lot after the relevant adjuvant treatment. Nowadays, the adjuvant treatment is mainly radiotherapy before and after surgery, especially radiotherapy before surgery will effectively control the scope of lesions and expand the possibility of safe margin selection, and also reduce the difficulty of anal preservation surgery. This patient’s tumor was 3 centimeters from the anus, and no adjuvant radiotherapy was given before and after the surgery, and radiotherapy was done in our hospital only two years after the surgery. 2. Awareness of negative lymph nodes The patient did not carry the pathology report of the surgery, and the previous medical record described lymph nodes 0/10 (numerator/denominator). The attending physician at that time thought that radiotherapy was not needed and gave oral Siroda for 6 months. For determining whether the pathological lymph nodes are negative after surgery, in addition to whether the numerator is zero, it is more important that the number of the denominator (indicating the extent of surgical debridement) has reached the basic value specified by each oncology specification. Lymph nodes in colorectal cancer require more than 12, so this case should be treated as positive, not to mention the age factor of the patient (less than 50 years old). Of course there is also the distance from the tumor to the lower incisional margin, which should be more than 2 cm, and in this case it was 1.5 cm. The narration here is too specialized, and the interpretation of pathology report needs experienced specialist physicians to have exact understanding. 3, the requirements of colonoscopy Colonoscopy can be done six months after surgery, and the annual routine examination is a basic action that must be performed afterwards. 4.Control of bowel movements Patients with colorectal cancer have more or less defecation problems after surgery, which require guidance from medical staff, especially for patients with low anal preservation, which require 3 – 6 months of counseling and intervention. Otherwise, it is difficult to reflect the effect of surgery and improve the quality of life, and even affect the psychological state of patients. In this patient, more than 4 years after surgery, no one gave life guidance and considered 6 bowel movements per day normal. For patients with total colectomy, after surgical reconstruction of multiple small bowel collaterals and dietary modification (increasing fiber foods, such as vegetables; controlling laxative foods, such as bananas), supplemented with antidiarrheal agents (flavopiridol, etc.), all can be controlled to about three times a day after 3 months. Therefore, for rectal cancer patients, the relative effect is much better. Of course the effect of radiotherapy also lasts for some time, and basically gradually returns to normal after 3 months. In a similar patient, there was an outpatient elderly woman a month ago who was counseled to adjust her diet for half a month, and the frequency of stools was reduced by half. There are other conditions in the patients consulted, and the examination and treatment opinions given are more complicated, so only the aspects with commonality are mentioned here. Each joint consultation is not only a personalized and reasonable treatment plan for patients and families, but also a communication and exchange of comprehensive tumor treatment concepts.