|Purpose: This study was examined to clarify the safety from consecutive R0 interphincteric resection.Patients: Since 2007 to 2016, 128 patients underwent R0 ISR for lower rectal cancer (Open: 24, Lap: 104). Mean age was 63.0 years old and males were 92. Preoperative CRT and lateral node dissection were performed for 15 patients (11.7%) and 34 patients (26.5%), respectively. Mean operative time was 320 minutes (Open 362, Lap 310). Median postoperative hospital stay was 10 days (Open 12, Lap 9) and anastomotic leak was observed 9 patients (7.0%). The loop stoma was created for all patients and stoma closure was performed for 87.5% in both Open and Lap group. Mean duration to stoma closure was 195 day in Open and 122 days in Lap group.Five-year-OS and 3-year-RFS according to stage was I: 92.3%, 84.6%, II: 80.8%, 85.6%, and III: 83.9%, 67.3%, respectively. Local recurrence(LR) was observed in 16 patients (12.5%) and 8 patients recurred at lateral lymph node or pelvic plexus which were outside of TME resection. LR according to stage was I: 4/54 (7.4%), II: 3/15 (20.0%), and 9/59 (15.3%). Only 1 patient (6.7%) ocurred LR after CRT.Conclusion: Short term results and Survivals were acceptable. However LR was relatively higher in Stage II and III. Because half of LR were extra TME site, preoperative CRT should be considered for ISR.