Inclusion Criteria:

- Patients with adenocarcinoma of the lower-middle third of the rectum proctoscopy
established by rigid proctoscopy, with histological confirmation and candidates of
colo-anal anastomosis;

- Patients over 18 years and under 75 years, who can tolerate neoadjuvant and surgical
treatment;

- Patients who undergo an ultra-low anterior rectal resection with total mesorectal
excision and nerve and sphincter-sparing with curative intention

- Any extension of the primary tumor (T 1-2-3-4) according to the TNM classification;

- Patients with or without lymph node metastasis (N - / +) and with or without
resectable distant metastases;

- Patients clinically without fecal incontinence prior to the current illness and with
a Wexner incontinence Score less than or equal to 5;

- Patients ASA I, II or III and adequate hematological, renal and hepatic function;

- Patients who signed informed consent.

Exclusion Criteria:

- Altered cognitive state(eg mental retardation or dementia) that prevents
collaboration in the study or patients who can neither read nor write

- Fecal incontinence (Wexner equal to or greater than 6);

- Previous surgery or proctological, colonic and anorectal functional disease

- Diagnosis of synchronous colorectal or any other active neoplasm;

- Patients ASA IV, V;

- Pregnancy and lactation;

- Rejection of the patient to sign the consent form.