Objective: To investigate the changes in perioperative indicators, recovery of anal function, and levels of systemic inflammatory response in patients with low rectal cancer after undergoing laparoscopic total mesorectal excision. Methods: In a retrospective study, 160 patients with low rectal cancer were divided into a study group and a control group based on different treatment regimens. The study group (n=81) underwent laparoscopic total mesorectal excision, while the control group (n=79) underwent open total mesorectal excision. Perioperative indicators, anal function recovery, inflammatory response, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Colorectal Cancer 29 (EORTC QLQ-CR29) scores, and complication rate were compared between the two groups. Results: Compared with the control group, the study group showed an increase in operation time (P <0.05), reductions in intraoperative blood loss, postoperative recovery time, and complications (P<0.05), and better improvements in anal function, inflammation control and quality of life (P<0.05). Conclusion: Laparoscopic total mesorectal excision is applied in the treatment of low rectal cancer, and it has obvious advantages in optimizing perioperative indicators, accelerating anal function recovery, and reducing inflammatory response.