AIM:To analyze oncological outcome of intersphinctericresection(ISR)in ultra-low rectal cancer with intent tospare colostoma.METHODS:From 1995 to 1998,patients with a non-fixed rectal adenocarcinoma(tumor stage T2)preserving thelower margin at 1-3 cm above the dentate line withoutdistant metastasis was enrolled(period Ⅰ).ISR was prac-ticed in eight patients,and their postoperative follow-up was at least 5 years.In addition,from 1999 to 2003,another 10 patients having the same tumor locationas period Ⅰ underwent ISR(period Ⅱ).Among those,6patients with T3-4-staged tumor received preoperativechemoradiotherapy.RESULTS:All patients received ISR with curative inten-tion and no postoperative mortality.In these case seriesat period Ⅰ,local recurrence rate was 12.5% and me-tastasis rate 25.0%;the 5-year survival rate was 87.5%and disease-free survival rate 75.0%.There was no localrecurrence or distant metastases in 10 patients with amedian follow-up of 30(range,18-47)mo at period Ⅱ.CONCLUSION:As to ultra-low rectal cancer,inter-sphincteric resection could provide acceptable localcontrol and cancer-related survival with no permanentstoma in early-staged tumor(tumor stage T2);more-over,preoperative concurrent chemoradiotherapy wouldmake ISR feasible with surgical curative intent in moreadvanced tumors(tumor stages T3-4). AIM: To analyze oncological outcome of intersphincteric rection (ISR) in ultra-low rectal cancer with intent tospare colostoma. METHODS: From 1995 to 1998, patients with a non-fixed rectal adenocarcinoma (tumor stage T2) above the dentate line withoutdistant metastasis was enrolled (period I). ISR was prac-ticed in eight patients, and their postoperative follow-up was at least 5 years.In addition, from 1999 to 2003, another 10 patients had the same tumor locationas period Ⅰ underwent ISR (period Ⅱ). Among those, 6patients with T3-4-staged tumor received preoperative chemotherapy last .RESULTS: All patients received ISR with curative intention and no postoperative mortality. In these case seriesat periodⅠ, local recurrence rate was 12.5% ​​and me-tastasis rate 25.0%; the 5-year survival rate was 87.5% and disease-free survival rate 75.0%. There was no local recurrence or distant metastases in 10 patients with amedian follow-up of 30 (range, 18- 47) mo at period Ⅱ.C ONCLUSION: As to ultra-low rectal cancer, inter-sphincter resection could provide acceptable local control and cancer-related survival with no permanent stoma in early-staged tumor (tumor stage T2); more-over, preoperative concurrent chemoradiotherapy wouldmake ISR feasible with surgical curative intent in more advanced tumors (tumor stages T3-4).