[Objectives] To compare the effectiveness of transpelvic and transperineal levator ani excision in laparoscopic abdominoperineal resection for rectal cancer. [Methods] Seventy-five patients with rectal cancer who received laparoscopic abdominoperineal resection in our department from January 2020 to June 2022 were retrospectively analyzed. Patients were divided into the transpelvic excision group (n=42) and the transperineal excision group (n=33) according to the procedure of levator ani excision. Operation time, intraoperative blood loss, lymph node yield, positive rate of circumferential resection margin of specimen, infection of perineal incision, and time to remove presacral drainage tube were compared between the two groups. [Results] The operation time and the time to remove presacral drainage tube differ significantly between the two groups (P0.05). [Conclusion] Transpelvic levator ani excision is a safe procedure in the laparoscopic abdominoperineal resection of rectal cancer, and it could shorten the operation time and promote recovery in patients when compared with transperineal levator ani excision.
