目的　探讨直肠癌术后局部复发的病因、诊断、再手术及并发症的防治。方法　对 35例直肠癌术后局部复发再手术者进行回顾性分析。结果　局部复发的 35例中 13例为吻合口复发 ,11例是远切缘距肿瘤 <3cm者。 9例盆腔淋巴复发者均是首次手术时有淋巴结转移的病例 ,其中 7例未做规范的淋巴结清扫。 12例未切除全部直肠系膜。结论　局部复发与首次手术时肠管切除不足 ,淋巴清扫不彻底 ,全直肠系膜切除不够及淋巴转移有关。定期复查 ,动态观察CEA有助于复发癌的早期发现和诊断。对能耐受手术又无广泛远处转移者给予再次手术 ,能获较好疗效 Objective To investigate the etiology, diagnosis, reoperation and complications of postoperative local recurrence of rectal cancer. Methods Retrospective analysis of 35 cases of rectal cancer after local recurrence and operation. Results of 35 cases of local recurrence in 13 cases of anastomotic recurrence, 11 cases of distal margin away from the tumor <3cm. Nine cases of pelvic lymph node recurrence were the first case of lymph node metastasis, of which seven cases did not do a standard lymph node dissection. 12 cases without resection of the total mesorectal membrane. Conclusion Local recurrence is not related to the first surgery for insufficient bowel resection, incomplete lymphadenectomy, inadequate total mesorectal excision and lymphatic metastasis. Regular review, dynamic observation of CEA contribute to the early detection and diagnosis of recurrent cancer. To be able to tolerate surgery without extensive distant metastasis given to re-surgery, can be a better effect