目的探讨直肠癌术后局部复发原因及治疗问题。方法对４１例直肠癌术后局部复发作回顾性研究。分析了直肠癌术后局部复发时间，局部复发部位，治疗情况和预后。结果本组患者中２４例首次手术为直肠经腹低位切除术（Ｄｉｘｏｎ＇ｓ术），其中１８例为吻合口复发，６例为盆腔复发。１７例首次手术为经腹会阴联合切除术（Ｍｉｌｅｓ＇术），均为会阴部复发。３２例（７８．０％）于术后２年内复发。本组３２例再次行根治性手术，术后无瘤生存１年内１１例，２年内６例，５例无瘤生存３年以上。结论外科手术仍是首选的治疗方法 Objective To investigate the causes of local recurrence after rectal cancer and the treatment issues. Methods A retrospective study was performed on 41 cases of rectal cancer after local recurrence. The local recurrence time, local recurrence site, treatment status and prognosis of rectal cancer were analyzed. Results Of the 24 patients in this group, the first operation was rectal low abdominal resection (Dixon’s surgery), of which 18 were recurrent anastomoses and 6 were pelvic recurrences. In 17 cases, the first operation was an abdominal perineal resection (Miles’ operation), both of which were recurrent in the perineum. 32 cases (78.0%) recurred within 2 years after operation. In this group, 32 patients underwent radical surgery again. After operation, 11 patients survived within 1 year, 6 patients within 2 years, and 5 patients survived without tumor for more than 3 years. Conclusion Surgery is still the preferred treatment