【Abstract】 Objective To investigate the survival rate, voiding, sexual function after nerve-sparing surgery with extended systematic extraperitoneal lateral lymphadenectomy in lower rectal cancer. Methods Three hundreds and ninety-two cases with advanced lower rectal cancer who underwent nerve-sparing surgery with radical dissection from 1996 to 2000 were reviewed. Among them,173 cases only cleared in abdominal cavity,219 cases coupled with extraperitoneal lateral lymphadenectomy. Results The metastatic rate of lateral lymph node was 17.8%(39/219),the rate of non-modal foci of metastatic disease in lateral out of the abdominal cavity was 5.9%(13/219).Local recurrence rate, the abdominal cavity group was 16.2%（28/173）; the coupled group was 9.6%（21/219）， P＜0.05. Conclusion By contrast,abdominal cavity coupled with extraperitoneal lympadenectomy acted to cut down local recurrence and to elevate 5-year survival rate,the postoperative quality of life with voiding, sexual function appeared to be seriously affected, although the radical dissection are nerve-sparing surgery.