Purpose: This study aimed to explore the effect of placement of double-lumen irrigation-suction tubes (DLIST) on the spontaneous closure of anastomotic leakages (AL) after rectal cancer surgery. Methods: The study was performed at two centers which was managed by the same chief. The treatment in the two center were same. From January 2011 to June 2020, patients with postoperative AL after rectal cancer surgery were eligible. Patients were divided into a passive drainage (PD) group and a DLIST group according to whether the PD,placed during the rectal cancer surgery, had been replaced with the DLIST. The effect of DLIST on the AL was evaluated.Result: There were 76 patients in the DLIST group and 52 in the PD group. The DLIST group was more inclined to achieve spontaneous closure of AL (HR =3.048; 95% CI: 1.787-5.197; P<0.001). Both length of stay and costs of the treatment in the DLIST group were lower (54 [41.25-117] days vs. 112 [66.75-127.75] days, P =0.005; and $18,721 [$14,982-44,960] vs. $40,840 [$20,932-50,529], P < 0.001).Conclusion: Placement of DLIST is an effective method for treating AL following rectal cancer surgery. Compared with PD, the cost of DLIST in the treatment of AL is lower and the length of stay is shorter.