To investigate the effects of different approaches of intersphincteric resection (ISR) on patients with low rectal cancer.

A total of 114 patients with low rectal cancer admitted from April 2022 to April 2025 were selected as the research subjects. They were randomly divided into the transanal group and the transabdominal group, with 57 cases in each group. Patients undergoing transanal ISR were included in the transanal group, and those undergoing transabdominal ISR were included in the transabdominal group. Statistical analysis was performed using SPSS25.0. Quantitative data were expressed as (±s), and independent sample t tests were used for group comparisons, while paired sample t tests were used for within-group comparisons; qualitative data were expressed as [cases (%)], and χ² tests were used for group comparisons. A difference was considered statistically significant if P<0.05.

The operation time of the transanal group was significantly higher than that of the transabdominal group (P<0.05); the time to first semi-liquid diet was significantly lower in the transanal group (P<0.05). One month after surgery, the Wexner score of the transanal group was significantly higher than that of the transabdominal group (P<0.05). Three months after surgery, the total complication rate of the transanal group was significantly lower than that of the transabdominal group (P<0.05). There were no significant differences in hospital stay, distance of the far resection margin, and total number of lymph node dissections between the two groups (P>0.05).

The treatment effects of transabdominal and transanal ISR on patients with low rectal cancer are similar. The transanal approach is more conducive to promoting the recovery of intestinal function compared to the transabdominal approach, but it has a lower risk of complications. However, compared with the transabdominal approach, the transanal approach is not conducive to the recovery of anal function.