Objective To evaluate the clinical effects of trans-anal ileus tube combined with laparoscopy for left-side acute malignant colorectal obstruction.Methods From March 2007 to April 2011,49 patients with left-side acute malignant colorectal obstruction were treated by trans-anal ileus tube.Curative effects were evaluated according to abdominal circumference,intra-abdominal pressure,drainage volume,patient's symptom relief and imaging examinations.After irrigation and drainage ranged from 9 - 11 d,the radical operations and anastomosis were performed by laparoscopy.Results The trans-anal ileus tube was successfully implanted in 45 patients.Abdominal circumference decreased from ( 101.0 ± 5.0) cm to (87.0 ± 3.0) cm (P=0.020) ; intra-abdominal pressure decreased from (26.5 ± 3.4) cm H2O (1 cm H2O =0.098 kPa) to ( 13.7 ± 2.8) cm H20 (P=0.015) ;drainage volume was 800 - 2500 ml/d.Estimated through X ray and CT,obstruction was relieved.Forty patients were performed radical resection and first stage anastomosis by laparoscopy after decompression,and there was no serious complication.Conclusion Decompression and drainage through trans-anal ileus tube combined with laparoscopic for left-side acute malignant colorectal obstruction were coincided with the principle of damage control surgery and fast track surgery.