With the advancement of surgical techniques, many surgeons use anal preservation surgery for patients with rectal cancer. However, for senior rectal cancer patients over 75 years old, preoperative evaluation is necessary before deciding the surgical plan. The disadvantages of anus-preserving surgery for elderly patients: 1. Some elderly patients usually do not pay attention to anal contraction exercise and have poor anal contraction function. The surgeon must assess the anal tension and anal contraction function during the preoperative rectal examination. The poor anal tension and contraction function indicate that the patient has poor sphincter control function and cannot effectively control defecation. 2. Some elderly patients suffer from dementia and are not very conscious. These patients have a poor response in feeling the urge to defecate and actively contracting the anus, often failing to contract the anus in time when the stool reaches the anus, often contaminating their clothes and pants with stool, and having poor cleaning ability. 3.Some elderly patients have poor legs and legs, so it is inconvenient for them to go to the toilet. After rectal cancer patients’ anal preservation surgery, most or almost all of the rectum used to empty the stool is removed, and the upper colon is connected to the anus. It takes some time for the “new” rectum to compensate, and it often takes 6-12 months for the patient’s bowel function to return to normal or nearly normal, and some patients will have permanent frequent bowel movements or constipation. In some cases, permanent frequent bowel movements or constipation may occur. For example, in elderly patients, the number of bowel movements is high after anal preservation surgery, and it is inconvenient to go to the toilet, which brings inconvenience and pain to the patients and their families. The above-mentioned patients can avoid unfavorable situation if they do rerouting (make stoma in abdomen), put stoma bag in abdomen after surgery, clean stoma bag every day and change stoma bag every 3-5 days.