Objective To find out the future research hotspot and trends of gastrointestinal stromal tumors（GISTs）research.Methods  Data were based on the Science Citation Index Expanded（SCIE），from the Institute of Scientific Information Web of Science database.Articles referring to GISTs during 20082017 were concentrated on the analysis of the number of papers published,number of pages of papers,number of citations,number of citations,the number of countries involved in the study of gastrointestinal stromal tumor,the number of journals and periodicals ranked among the top 20 in terms of the number of papers related to gastrointestinal stromal tumor,and the number of keywords in the top 32 in terms of the accumulated number.Results  This searching strategy located 10，440 publications on GISTs in the SCI database.The cumulative number of publication followed linear distribution（R2=0.9994）.The three most prolific journals are Journal of Clinical Oncology and Annals of Oncology，responsible for 5.88 % of the publication.The change trends of author keywords may reveal the changes of research spots.Conclusion  DOG1 and immunotherapy will undoubtedly maintain the hotspots of GISTs research in the next few decades.

Objective   To investigate the clinical outcome of laparoscopic D2 radical distal gastrectomy in the treatment of elderly patients with advanced gastric cancer，and to investigate its effect on the expression of peritoneal lavage levels of dopamine Decarboxylase(DDC)，Hypoxia Inducible Factor1α(HIF1α)and serum levels of hypoxiainducible factor1α(HIF1α)，metastasis associated with colon cancer 1(MACC1).Methods  120 cases of elderly patients with advanced gastric cancer undergoing radical gastrectomy were divided into laparoscopic group(n=60)and open group(n=60)，patients received laparoscopic and open D2 radical distal gastrectomy respectively in the two groups.The perioperative conditions，survival，recurrence and metastasis rate between the two groups were compared.The serum levels of HIF1α，MACC1 and peritoneal lavage levels of CEA and DDC were measured preoperatively and postoperatively.Results  The operative time，number of lymph nodes dissected,length of proximal margin to the cancer，length of distal margin to the cancer and postoperative complication rates in laparoscopic group〖LM〗were(163.05±15.41)min，26.89±4.55，(7.04±1.13)cm，(6.13±1.04)cm and 3.33%，respectively，which were no significant differences with open group[(158.23±13.44)min，28.41±5.23，(7.22±1.28)cm，(6.02±1.13)cm，11.67%](P>0.05).The length of incision，intraoperative bleeding，postoperative flatus time，diet intake time，ground activity time and hospital stay in laparoscopic group were(5.23±1.26)cm，(155.01±30.21)ml，(4.12±0.65)d，(4.15±0.71)d，(2.91±0.44)d，(12.69±2.45)d，respectively ，which were significantly lower than(16.32±2.53)cm，(351.91±42.16)ml，(5.13±1.02)d，(5.22±1.14)d，(4.82±1.13)d，(18.12±4.43)d in the open group(P<0.05).The peritoneal lavage levels of CEA，DDC and serum levels of HIF1α，MACC1 after operation in laparoscopic group were(1423.49±331.56)ng/ml，(115.03±30.21)ng/ml，(45.02±10.03)pg/ml，(76.69±12.45)pg/ml,respectively ，which were significantly lower than open group[(2812.43±702.48)ng/ml，(168.40±47.19)ng/ml，(61.45±15.44)pg/ml，(104.46±15.96)pg/ml](P<0.05).The 1，3and 5year survival rates were respectively 96.49%，83.64% and 60.87% in laparoscopic group，showed no significant differences with open group(94.55%，80.77%，59.52%)(P>0.05).There was no significant difference in the average postoperative survival time between the two groups(P>0.05).The recurrence and metastasis rate was 14.04% and 25.45% in laparoscopic and open group，respectively(P>0.05).conclusion  Laparoscopic and open D2 radical distal gastrectomy had similar radical effect in the treatment of elderly patients with advanced gastric cancer，while laparoscopic surgery has the advantages of minimally invasive and rapid postoperative recovery and may reduce the risk of micrometastasis.

Objective  To study the expression level of SIRT7 in the gastric cancer，analyze the correlation between SIRT7 and clinicopathological characteristics of gastric cancer，and explore possible mechanisms of the involvement of SIRT7 in the occurrence and development of gastric cancer.Methods 195 cases of gastric carcinoma and paracarcinoma tissues were collected.Western blot was used to detect the protein expression of SIRT7 in gastric carcinoma and adjacent tissues.Immunohistochemistry was operated to detect the expression of SIRT7 and the correlation between SIRT7 and clinicopathological characteristics of gastric cancer.Results The positive rate of SIRT7 expression in gastric cancer（65.64%）was significantly higher than in the adjacent tissues（19.49%）（P<0.05）.The expression of SIRT7 was not related to age，gender and the size of tumor（P＞0.05），but related to lymph node metastasis，depth of invasion and TNM staging（P<0.05）.Conclusion  The expression of SIRT7 in gastric cancer is higher than in normal tissues，and is correlated with lymph node metastasis，depth of invasion and TNM staging，suggesting their roles in the gastric cancer.

〓Objective  To investigate the expression of micro RNA31(miR31)in colon cancer tissue and its correlation with prognosis，and to study the effect and mechanism of the invasion and metastasis of colon cancer.Methods Pathological specimens of 43 patients undergoing surgical treatment for primary colon cancer.Real time quantitative PCR(quantitative realtime PCR)was used to detect the expression of miR31 in colon cancer tissue，and the relationship between miR31 expression and prognosis and pathological grading was analyzed.The transfection method of liposome mediated transfection was used to transfect human colon cancer HT29 cell line with miR31mimic and miR31 negative control respectively.The effect of miR31 on cell migration ability was detected by scratch test，and the effect of miR31 on cell invasiveness was detected by Transwell test.The effects of miR31 on the Wnt/ betacatenin signaling pathway and the important target gene Claudin1 were detected by Westernblot.〖WTHZ〗Results〖WTBZ〗〓The colon cancer TNM stage Ⅰ ～ Ⅱ expression of miR31 patients was 1.78±0.25,while in patients with stage Ⅲ～Ⅳ was 2.35±0.41（P＜0.05）.The expression of tumor penetrating serosa in patients with miR31 was 2.34±0.47，while that in patients without metastasis was 1.67±0.35（P＜0.05）.The expression of miR31 in patients with lymph node metastasis was 3.49±0.42,expression of miR31without lymph node metastasis was1.64±0.71（P＜0.05）.The expression of vascular invasion in patients with miR31 was 3.31±0.58,that without the occurrence of vascular invasion patients was 2.18±0.63（P＜0.05）.In human colon cancer HT29 cells，the percentage of healing area in miR group(0.74±0.16）was significantly higher than that in NC group（0.43±0.21），the difference was statistically significant(P＜0.05).The number of membrane cells in group miR(182.7±29.3)was significantly more than that in group NC(139.2±25.6，P＜0.05).The expression of epithelial marker Ecadherin in miR group(0.51±0.24)was significantly lower than that of NC group(0.89±0.19，P＜0.05).In addition，activation of betacatenin expression was significantly higher in miR group(1.01±0.23)than that of NC group(0.65±0.24,P＜0.05).The expression of Claudin1 was significantly higher in miR group(0.46±0.17)than that of group NC(0.21±0.12;t=2.69,P＜0.05).Conclusion  miR31 abnormal activates the Wnt/catenin signaling pathway，resulting in overexpression of Claudin1，promoting colon cancer invasion and migration，and affecting the EMT.In colon cancer，miR31 may play a role in promoting cancer.

  Objective   To investigate the comparison of clinical efficacy、immune inflammatory response and prognosis of single port laparoscopic radical surgery and routine laparoscopic radical resection for rectal cancer of old patients. Methods To screening 80 cases of old patients with rectal cancer as research subjects，it will be divided into study group with 40 cases and control group with 40 cases，patients in control group were given routine laparoscopic radical resection treatment and patients in study group were given single port laparoscopic radical surgery，then the two groups were compared in terms of clinical efficacy and so on.Results The slash length（2.8±0.4）cm，hospital stays（7.9±1.8）d,postoperative first exhaust time（2.6±1.4）d and postoperative VAS score（2.6±0.4）in study group were better than the control group（P<0.05）; There was no significance difference between study group and control group in postoperative complications rate（7.5% vs 12.5%,P＞0.05）; The immune inflammatory response indexes were all better in study group than in the control group after the treatment（P＜0.05）; There had no significance difference between study group and control group in 1 year survival rate（87.5% vs 85.0%）and recurrence rate（5.0% vs 7.5%）after operation（P＞0.05）.Conclusion  The single port laparoscopic radical surgery in the treatment of old patients with rectal cancer is significant，but must strictly control the surgical indications.

  Objective  To observe the occurrence of anastomotic fistula after laparoscopic colorectal cancer resection with indocyanine green imageing，and to determine whether indocyanine green imaging is effective in preventing laparoscopic colorectal cancer anastomotic fistula. Methods  Randomly selected 145 patients with laparoscopic colorectal cancer resection，82 patients in control group，63 patients with indocyanine green imageing（ICG group）.The time of operation,the amount of bleeding during operation,the number of anastomotic leakage and the number of deaths caused by anastomotic leakage were observed. Results   In the control group，there were 7 patients with anastomotic fistula（2 with left hemitomy，1 with right hemicolectomy,4 with low rectal resection）and 1 case died from anastomotic leakage.In ICG group，only one patient undergoing lower rectal resection had anastomotic fistula，and none dead case.There was a significant difference between the two groups in the incidence of anastomotic leakage（f=2.337，P<0.05）. Conclusion Indocyanine green imaging can be used to reduce postoperative anastomotic leakage with laparoscopic colorectal cancer surgery.

Objective  To evaluate the predictive factors associated with pathological complete response after preoperative neoadjuvant chemoradiotherapy for local advanced recta cancer.Methods  A retrospective analysis was performed on the clinical data of 88 patients with rectal cancer,who underwent neoadjuvant chemoradiotherapy fellowed by radical surgery，all patients received 48～50 Gy of radiotherapy,each 2GY,concurrent fluorouracilbased chemotherapy and then accepted radical surgery after 6～8 weeks,the clinical factors associated with pCR and nonpCR were analysed by logistic regression.results  Eightyeight patients were enrolled and 10 patients achieved pCR after operation.The pCR rate was 11.4%.Univariate analysis showed that the maximum tumor diameter,T stage,N stage,pathological type,pretreatment serum CEA level correlated with tumor pCR level.Multivariate analysis showed that N stage and pretreatment serum CEA level were the independent predictive factors affecting pCR after neoadjuvant chemoradiotherapy for rectal cancer.Conclusion Pretreatment clinical factors,such as low N staging and low serum CEA levels,may be associated with pCR after neoadjuvant chemoradiotherapy for rectal cancer.

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  Objective  To analyzethe value and curative effect of hand assisted laparoscopy in patients with obesity and colorectal cancer.Methods  90 patients with obesity and colorectal cancer admitted in our hospital,they were divided into observation group and control group according to random number method and 45 patients in each group.The observation group were taken HALS surgery,the control group were taken open surgery.The operation conditions,postoperative condition and stress response of the two groups were compared.Results  There was no significant difference in operation time,number of lymph node dissection between the two groups(P>0.05).The anesthesia time,blood loss and incision length  in the observation group were significantly less than those in the control group(P<0.05).Postoperative body temperature recovery time,anal exhaust time,ambulation time,eating time,hospitalization time in the observation group was significantly shorter than the control group(P<0.05).Before operation,there was no significant difference between the two groups in the levels of interleukin6(IL6),CRP,cortisol and adrenocorticotropic hormone(ACTH)(P>0.05),after two days of operation,the levels of IL6,CRP,cortisol,interleukin6,Creactive protein,cortisol and adrenocorticotrophic hormone in patients with ACTH were significantly higher than those before operation(P<0.5).The level of observation group was significantly lower than that of control group(P<0.05).There was no significant difference in postoperative analgesia between the two groups(P>0.05).The complication rate in the observation group was significantly lower than that in the control group(P<0.05). Conclusion  HALS surgery in patients with obesity and colorectal cancer can reduce the amount of intraoperative bleeding and reduce the degree of involvement,is conducive to the recovery of patients as soon as possible,and reduce the incidence of complications.
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  Objective  To investigate the effect of restrictive transfusion practice on anastomotic leakage and infectious complications after surgery of rectal cancer.  Methods  Patients with rectal cancer receiving restorative proctectomy were divided into four groups based on the perioperative lowest haemoglobin（Hgb）level and transfusion status：Group 1 with Hgb level ≥100g/L and Group 2 with Hgb level ≥70g/L and <100g/L，neither group receiving a blood transfusion;Group 3 with Hgb level ≥70g/L and <100g/L and Group 4 with Hgb level <70g/L，both of whom received transfusion.Clinical characteristics，anastomotic leakage and infectious complications within 30 days of surgery were compared.Results  A total of 289 patients with a mean age of(58.2±10.8)years.There were 121（41.9%），115（39.8%），32（11.1%）and 21（7.3%）patients in Group 1，2，3，and 4，respectively.There were statistically significant differences among the groups in the rates of chemotherapy use，periperative Hgb，preoperative albumin level，intraoperative blood loss，tumour size and tumor stage.The unadjusted rates of overall infectious complications were 16.5%，28.7%，40.6% and 52.4% in the Group 1，2，3 and 4，respectively.Conclusion  Blood transfusion for perioperative Hgb level ≥70g/L is associated with higher postoperative surgical site infection，overall infectious complications and postoperative anastomotic fistula in rectal cancer patients.
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Objective   To investigate the application value of regulative dualchannel digestive tract reconstruction in gastric cancer surgery.    Methods   A total of 82 patients with gastric cancer who underwent radical surgery were selected as the study subjects,the random digital table was divided into 41 cases in the control group and 41 in the observation group,RouxenY anastomosis was performed after gastrectomy in the control group,and regulative dualchannel digestive tract reconstruction was performed after gastrectomy in the observation group.The operation and postoperative recovery,the changes of gallbladder systolic function and nutritional status before and 3 months after operation,the incidence of postoperative complications of two groups were observed.  Results  Compared with the control group,the time of digestive tract reconstruction in the observation group was statistically significant(P<0.05),the differences in intraoperative blood loss,postoperative anus exhaust time,postoperative defecation time and postoperative hospital stay of two groups were not statistical significance(P>0.05).There was no significant difference in gallbladder contractile function and nutritional status between the two groups before operation(P>0.05),The fasting gallbladder volume,postmeal gallbladder volume,gallbladder contraction rate and thethe serum total protein(TP),hemoglobin(HGB)and albumin(ALB)levels in the observation group at 3 months after operation were compared with those of the control group at the same time,the difference was statistically significant(P<0.05).The incidences of postoperative pulmonary infection,anastomotic stenosis,and anastomotic bleeding in the observation group compared with the control group,the difference was not statistically significant(P＞0.05),the incidences of postoperative dumping syndrome,reflux esophagitis,and gallstones in the observation group compared with the control group,the difference was statistically significant(P<0.05).Conclusion  The application of regulative dualchannel digestive tract reconstruction in radical gastrectomy of gastric cancer can effectively improve the nutritional status of patients,has little effect on the contraction of gallbladder,and can significantly reduce postoperative complications,worth popularizing.
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Objective    To evaluate the safety and clinical efficacy of standard transcutaneous holmium laser lithotripsy combined with microchannel technique in the treatment of complicated renal calculi.Methods Retrospective analysis of 90 cases of complex kidney stones in patients with clinical data in our hospital with a standard channel joint microchannel(F22+ F16)percutaneous nephroscope holmium laser lithotrips,and the operation time,intraoperative blood loss,the first phase of stone clearance rates and complications such as indicators for analysis. Results  81 cases were treated with stage Ⅰ standard channel joint microchannel percutaneous nephroscope holmium laser combined with microchannel technology,intraoperative blood loss was(94.71±20.58)ml,the overall stone removal rate of stage Ⅰ  reached 91.11%,and the postoperative complications were 9 times in total,which were cured after treatment.(Only 1 case of delayed hemorrhages line interventional embolization).Conclusion Standard transcutaneous transcutaneous holmium laser lithotripsy combined with microchannel technology for complicated renal calculi has the advantages of high net stone rate and low complications,which can be used as a feasible,safe and effective surgical method for complicated renal calculi.
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   Objective    To investigate the effect of controlled step decompression on the clinical prognosis of patients with severe traumatic brain injury.Methods  159 patients of severe traumatic brain injury were divided into control group（68 cases）and observation group（91  cases）according to the treatment method.Patients in control group received decompressive craniectomy，while patients in observation group received controlled staircase decompression.The time of operation and volume of bleeding were recorded;GCS score was used to evaluate the recovery of neurological function at before treatment，day 3，day 14 and day 30;Complications after operation between the two groups were compared.GOS scores were used to assess patient recovery at 90day and 1year.Results The intracranial decompression time and operation time of the patients in the observation group were significantly shorter than those in the control group[（11.89±4.10）min vs(34.47±10.03)min,(1.47±0.43)h vs(1.81±0.51)h,P＜0.05，respectively）.The volume of bleeding during the operation of the observation group was less than that of the control group[（103.1±29.8)ml vs(121.0±33.3)ml,P＜0.05）].The observation group recovered significantly better than the control group at 14 days after treatment（P<0.05）;The incidence of complications in the control group was higher than that in the observation group（20.59% vs 9.89%,P<0.05）; The GOS score of the observation group was significantly better than that of the control group at 90 days and 1 year followup（P<0.05）;The mortality of the patients in the observation group(3.30%)was significantly lower than that in the control group(5.88%)（P<0.05）.Conclusion Controlled step decompression can shorten the operation time and reduce the volume of bleeding of patients with severe traumatic brain injury，and improve the clinical prognosis of the patients.
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Objective    To investigate the causes and explore effective treatments of iatrogenic bile duct injury（IBDI）.Methods   Clinical data of 13 iatrogenic bile duct injury patients，who were analyzed to summarize the causes of bile duct injury and the experience of treatments.  Results  Among the 13 cases with IBID，2 cases were accessory right hepatic duct injury，7 cases were due to confused anatomic dissection of the gallbladder triangle，2 cases were caused by electric cauterization，common bile duct of 1 case was clamped due to excessive traction，and 1 injury was caused by adhesion and compression of biologic adhesive.For the treatments，4 patients received intermittent suture of bile duct plus T tube drainage，5 patients received bile duct endtoend anastomosis plus T tube drainage，and 4patients were treated by RouxenY biliaryenteric anastomosis.Except for one case of failure，the other 12 cases were successfully cured in the initial repair operation.Conclusion  IBDI was often caused by unclear anatomy and rough operation.Most of the lesions locate in the upper and middle part of the common bile duct.The RouxenY anastomosis is a safe and effective surgical procedure for IBID treatment.More importantly，prevention is the basic way to avoid IBID.

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  [Abstract]  Objective   To investigate the efficacy of laparoscopic surgery in the treatment of acute cholecystitis and its effects on intercellular adhesion molecule1(ICAM1),proteins of the matrix metalloproteinase9(MMP9)and vascular endothelial growth factor(VEGF).Methods  100 patients with acute cholecystitis admitted to our hospital were divide them into two group with the random number table.50 cases were treated with laparoscopic cholecystectomy(group LC)and other 50 cases were treated with open cholecystectomy(group OC).At the same time,50 healthy subjects were selected as the control group.The curative effect,postoperative complications,serum ICAM1,MMP9 and VEGF concentrations in patients before and after surgery were observed. Results The operation time(48.34±10.50)min,intraoperative blood loss(51.36±7.42)ml,intestinal function recovery time(43.47±5.62)h and postoperative hospital stay(4.89±1.06)d were significantly shorter in the LC group than in the OC group[（73.91±11.68）min,（92.45±8.63）ml,（71.59±8.15）h and（9.12±1.45）d,P<0.05].The number of complications such as incision infection in 2 cases,0 cases of bile duct injury,1 case of ascites and 1 case of aspiration pneumonia in the LC group were significantly lower than those in the OC group(P<0.05).The serum levels of ICAM1 was(0.34±0.04)ng/mL,MMP9 was(12.08±1.74)ng/mL and VEGF was(164.52±15.74)pg/mL were significantly lower in the LC group than in the OC group[（0.40±0.03）ng/ml,（15.65±1.68)ng/ml and（197.86±15.64）pg/ml,P<0.05.Conclusion Laparoscopic surgery has a good clinical efficacy in the treatment of acute cholecystitis,and the incidence of postoperative complications is low.It can effectively improve the expression of ICAM1,MMP9 and VEGF in patients.
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Objective   To evaluate the clinical efficacy of posterior laminectomy in the treatment of intraspinal neurilemmoma. Methods  A total of 35 cases with intraspinal neurilemmoma was reviewed retrospectively in retrospective study.Of all cases，6 cases had defect in cervical spine，10 in thoracic，19 in lumbar of sacral.4 cases had dfect in intramedullary，21 in intradural extramedullary，10 cases in epidural and 8 cases were dumbbell shaped.All patients were treated with posterior laminectomy，of which 9 cases of nerve roots which can not be separated from the tumor were removed.Internal fixation was performed in 28 cases.Patients were followed up for the clinical effects.Xray and CT were performed to observe spinal stability and bone graft fusion.MRI were performed to observe the tumor recurrence. Results The tumors of  all 35 patients were completely resected，and all of them were neurilemmomas agter pathological examination.The operation time was 2～6 h，with an average of 3.6 h，and blood loss was 300～900 ml，with an average of 450 ml.After  the operation，1 case had sensory and motor dysfunction in the lower extremities，no obvious hematoma and spinal cord compression in MRI.The spinal cord ischemia reperfusion injury was considerd，and large dose of methylprednisolone was given in time，and the treatment of dehydration and nutrition nerve was given.The symptoms were improved obviously.The CSF leakage was found in 21 patients.The followup time was 3～34 months，with an average of 18.2 months.All the patients showed significant improvement in clinical symptoms and neurological function，and no recurrence occurred.No sponndylolisthesis and instability phenomena were observed in all 35 patients. Conclusion Posterior laminectomy can be effective in the  treatment of intraspinal neurilemmoma and can be better exposed and completely resected with microscope technique.
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  Objective    To evaluate the treatment and the clinical effect of arthroscopic tratment of the injury of the subscapularis.  Methods  A retrospective analysis of subscapularis injury patients who had arthroscopic surgery.Rivet with wire was implanted in the foot of the subscapularis and using single row suturing during operation.Before and after operation with UCLA score and ASES score evaluation of shoulder function recovery.  Results  The followup time of 9 months to 18 months,an average of(11±5.1)months.Preoperative UCLA score(14.8±3.2)points,the last followup UCLA score(32.3±2.0),preoperative ASES score(56.7±8.8)%,the last followup ASES score(88.1±7.5)%.8 cases of excellent,good in 14 cases and poor in 2 cases,the excellent rate was 91.67%.   Conclusion   The injury of the subscapularis,especially in the partial ones,the arthroscopic surgery can improve the accuracy of diagnosis,and the trauma is small and the function is quickly restored.
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Objective  To analyze and discuss the efficacy and safety of proximal femoral nail anti rotation（PFNA）fixation for osteoporotic femoral intertrochanteric fractures.Methods  A total of 89 patients with osteoporotic intertrochanteric fractures were included in the study and divided into observation group including 44 patients receiving proximal femoral nail antirotation surgical treatment.The control group included 45 patients receiving dynamic hip screw（DHS）surgical treatment.The efficacy and safety of the two groups were compared and analyzed. Results The operation time of the observation group[（67.53±8.47）min] was lower than that of the control group[（102.41±8.05）min] and the blood loss was also lower than that of the control group[（170.25±23.67）ml vs（430.58±26.37）ml]，and the difference was statistically significant（P<0.05）.Efficacy evaluation showed that the proportion of patients with poor efficacy in the observation group was lower than that in the control group.There was no statistically significant difference between the two groups in fracture healing time and rate of effectiveness（P>0.05）.The Harris score of the observation group after surgery was 83.22±12.05，and that of the control group was 80.45±15.14.There was no significant difference（P>0.05）between the two groups.Conclusion The treatment of osteoporotic femoral intertrochanteric fractures with proximal femoral nail antirotation has a shorter operation time，less intraoperative damage，and a low risk of various complications.It has many advantages.
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 Minimally invasive surgery has become the focus of modern surgical therapy for colorectal cancer，and as one rising star of it，NOSES has been widely applied and developed in China.Compared with rectal cancer，intracorporeal colonic anastomosis is more complex and difficult.With the continuous development of surgical technology，intracorporeal colonic anastomosis in NOSES becomes mature and diversified.Peristaltic anastomosis and antiperistaltic anastomosis are two main ways classified according to the relationship of anastomosis direction and intestinal peristaltic direction，among which deltashaped anastomosis and overlapped deltashaped anastomosis are the most representative surgical technique respectively.In this artical，we offer a detailed overview of evolution of intracorporeal colonic anastomosis in NOSES，main surgical processes of representative technique and currently relative arguments.After summarization of the key points in intracorporeal colonic anastomosis on the basis of previous researches，we are also looking forward to better intracorporeal colonic anastomosis in NOSES in the future.
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  Low rectal cancer is treated with transabdominal perineal resection（APR），which does not preserve the anus and requires permanent colostomy.In recent years，sphincter resection（ISR）has become a research hotspot，which can achieve radical resection of low rectal cancer and preserve the anus.Currently，there are various types of ISR for rectal cancer.The application of laparoscopic technology has created a new era for the anus preservation of low rectal cancer.This article reviews the progress of different approaches to laparoscopic ISR in the treatment of patients with low rectal cancer，and provides individualized anal sphincter surgery for patients with low rectal cancer.

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