Abstract:Objective To evaluate the operative indications and technique of combined total mesorectal excision （TME）with modified Bacon procedure for treatment of very low rectal cancer.
Methods Seventysix cases who was proven very low rectal cancer in which the distance between the anal verge and the lower margin of the tumor was 4-8 cm underwent combined abdominal and trans anal TME and modified Bacon procedure with use of selfmade anal retractor.
Results There was no operative mortality or anastomotic fistula, and in all cases the operation was successful. The followup was 1-5 years. Local postoperative recurrence developed in 5 cases（6.58%）in 1-2 years, and 2 cases had anastomotic stenosis. The 1,3, and 5year survival rate was 100%,80.83%, and 68.37%, respectively. Defecation was under satisfactory control 3~6 months after operation and restored to normal in 6 months.
Conclusions Combined TME and modified Bacon procedure is a safe and effective method for treatment of very low rectal cancer of Dukes stages A, B and C cases without distant metastasis.