[Surgical treatment of rectal cancer]

Based on natural history, the localization, stage and grading of rectal carcinomas the abdomino-perineal excision is no longer the routine procedure. Over 50% of the patients should be suitable for a sphincter saving operation. Local excision is justified under certain circumstances. The morbidity and lethality of the operation have decreased considerably; the cure rate has not changed during the past decade. Future improvements may be expected from new adjuvant treatments, individualization of adjuvant therapy and more aggressive surgical therapy.