To explore the effect of different ligation sites of inferior mesenteric artery (IMA) on perioperative period and complications in patients with low rectal cancer.

Data of 142 patients with low rectal cancer from August 2021 to August 2023 were retrospectively analyzed. According to different surgical methods, 72 patients with laparoscopic high ligation were divided into high group and 70 patients with laparoscopic low ligation were divided into low group. SPSS 22.0 statistical software was used to analyze the data. Perioperative indicators were expressed as (), and independent sample t test was performed. The complications, recurrence and death were examined by χ² test. P<0.05 was considered to be statistically significant.

The postoperative exhaust time in the high group was higher than that in the low group, the incidence of urinary incontinence one month after surgery (2.8% vs. 11.4%) was lower than that in the low group, and the incidence of low anterior resection syndrome (51.4% vs. 34.3%) was higher than that in the low group 3-6 months after surgery, with statistical significance (P<0.05). Other perioperative indexes, complications, recurrence, metastasis and mortality were not significantly different from those in the lower group (P>0.05).

Laparoscopic low ligation of intestine can promote postoperative intestinal function recovery in patients with low rectal cancer, with a lower incidence of short-term complications, while high ligation has less damage to autonomic nerve plexus and a lower incidence of postoperative urinary incontinence.