腹腔镜手术已广泛应用于直肠癌治疗之中，针对我国以低位和超低位直肠癌为主这一特点，如何合理选择手术方式以兼顾肿瘤根治和功能保护的目标，是值得深入探讨的临床问题。腹腔镜低位直肠癌手术方式多样，应重视患者术前评估，精准把握新辅助治疗指征，以肿瘤根治性切除为基本出发点，严格掌握保肛手术适应征，根据具体病例个体化选择手术方式。

Laparoscopic surgery has been widely utilized in the treatment of rectal cancer. Considering the predominance of low and ultra-low rectal cancer in China，the rational selection of surgical approaches to achieve both tumor eradication and functional preservation is a clinically significant issue that warrants in-depth investigation. There is a wide range of laparoscopic techniques available for low rectal cancer，necessitating careful preoperative evaluation and precise determination of indications for neoadjuvant therapy. The fundamental objective should be achieving oncological clearance while ensuring appropriate selection of sphincter-preserving procedures. The choice of surgical approach should be personalized according to individual patient characteristics.