RESUMO
Organ function preservation emphasizes the application of various therapeutic techniques to avoid or reduce the influence of tumor treatment process on the normal function of cancer organs and adjacent organs under thepremise of ensuring the best prognosis of oncology. Modern surgical treatment of middle and low rectal cancer does requireanal organ function preservation, but the current rectal cancer guidelines lack guidance on how to protect organ function. Inthe author's opinion,modern colorectal surgeons should recognize that anal function is an important factor affecting the quality of life after rectal cancer surgery. Functional considerations should be raised to the same level as techniqueas to whether the patient should preserve the anus. Correct evaluation of postoperative defecation function of patients isthe basis of selecting anal preservation indications.Preoperative evaluation of risk factors for anal dysfunction are helpful to predict postoperative functional status. The rational use of multidisciplinary strategies is recommended to reduce surgical trauma and improve anastomosis techniques to achieve functional preservation in middle and low rectal cancer.