Background and purpose: Postoperative anastomotic fistula of rectal cancer is one of the serious complications

and the incidence of anastomotic fistula is a clinical problem. This study aimed to explore the rate and risk factors of anastomotic leakage in sphincter-preserving surgery of rectal (Dixon surgery) with dual stapler technique. Methods: A retrospective study was conducted on 150 patients with rectal cancer. All patients underwent anterior resection with dual stapler technique. Patients’ clinical characteristics

including gender

age

body mass index (BMI)

tumor grade

anastomotic location

TNM stage

comorbidity and preoperative treatment

were included in univariate and multivariate analyses. Results: A total of 7 cases (4.7%) had anastomotic leakage

among which 3 cases were cured by ileostomy and the other 4 cases were cured by conservative therapy. Univariate and multivariate analyses found that the location of anastomosis and preoperative chemoradiotherapy were independent risk factors for anastomotic leakage. Conclusion: Dual stapler technique was a safe technique to achieve low anastomotic leakage rate. The location of anastomosis and preoperative treatment were independent risk factors for anastomotic leakage.