Aim. To compare the options for surgical treatment of rectal cancer in patients with tumors localized in the middle and lower ampulla of the rectum. Materials and methods. We performed the analysis of the results of treatment of patients with rectal cancer, who underwent abdominoperineal resection of the rectum with passing the sigmoid colon into the anal canal and low anterior resection of the rectum with the formation of stapled coloanal anastomosis. Results. We studied 2 groups of patients: Primary group (low anterior resection of the rectum) and control group (abdominoperineal resection). Not only oncological indices (five-year survival rate), but also the quality of life of the patients (Wexner scale) were compared. After a year after surgical treatment, an improvement in retention function in both groups was registered. However, 17 (25%) patients in the control group noted unsatisfactory function of the sphincter apparatus (Wexner score — 11—20 points), sharply limiting their social activity and requiring the use of anal tampons. Also, incontinence issues of various degrees were present in 63 (95%) of patients in the control group after the first year. Analysis of the condition of patients of the primary group revealed a significant improvement in the quality of life associated with satisfactory function of the sphincter apparatus of the rectum. According to the questionnaires in 40 (45%) people out of 88 who survived 1 year, no significant impairment of the sphincter function was found, which affected their social adaptation. Other patients had symptoms of fecal incontinence or inability to hold feces for a long time (Wexner score — less than 10 points). Conclusion. The use of a low anterior rectal resection with the formation of stapled coloanal anastomosis significantly improves the quality of life of patients without compromising the radicalness and safety of treatment.