Rectal syndrome caused by locoregional evolution of low rectal cancers and anal cancers is prevented and treated by surgical resection. But, for old patients with multiple tares, carcinologic surgical resection as abdominoperineal amputation can not be considered. Management of rectal syndrome becomes a therapeutic challenge. We reported a prospective serie of 5 patients more than 80 years old with multiple tares, treated by rectal amputation by pure perineal approach with laparoscopic colostomy. This surgery avoided for all patients trying rectal symptoms and maintained acceptable quality of life with fast coming back at home. The palliative treatment of low rectal cancers or anal cancers combining rectal amputation by pure perineal approach with laparoscopic colostomy may be an interesting therapeutic option for patients who cannot undergoing aggressive carcinologic surgical treatment.