ObjectiveTo compare the short-term outcome of 3-port and 5-port laparoscopic assisted radical resection for middle and high rectal cancer.MethodsWe retrospectively analyzed the clinical characteristics of 67 patients with middle and high rectal cancer who were treated in the Gastrointestinal Ward of Center of General Surgery in General Hospital of Western Theater Command of the Chinese People’s Liberation Army from January 2018 to December 2018. The operative, pathological, recent postoperative related indicators, and follow-up results of the two groups were compared and analyzed.ResultsAmong all the enrolled patients, 33 cases received 3-port laparoscopic surgery (3-port group) and 34 cases received 5-port laparoscopic surgery (5-port group). The total length of incision and the pain score of the Visual Analog Scale (VAS) on the 3rd postoperative day of the 3-port group were significantly better than those of the 5-port group (P<0.05). Peripheral incisal margins were negative in both two groups. However, there were no statistically significant differences in indicators such as operative time, intraoperative blood loss, operative conversion rate, hospitalization expenses, length of the distal margins, number of positive lymph nodes, number of lymph nodes harvested, time to the first flatus, time to the first ambulation, time to urinary catheter removal, time to drainage tube removal, time to the first oral intake, postoperative hospital stay, and postoperative complication rate (P>0.05). Thirty cases of the 3-port group were followed up for 12–24 months (median of 19 months), as well as 29 cases of 5-port group were followed up for 12–24 months (median of 19.5 months). There were no significant differences on the incidences of intestinal obstruction, local recurrence, distant metastasis, and death between the two groups (P>0.05).ConclusionCompared with the conventional 5-port laparoscopic surgery, the 3-port laparoscopic surgery could shorten the total length of incision and reduce the surgical trauma, suggesting that it is safe and effective.