[Radical surgery and/or continence preservation in rectal cancer]

Low anterior resection has been compared with abdominoperineal excision in the treatment of carcinoma of the upper and middle third of the rectum concerning operative mortality, morbidity, 5-year survival rates, local recurrences and life quality. There is no evidence that abdominoperineal excision is preferable. On the contrary in terms of recurrence and possible additive radiation low anterior resection seems to be the better choice. Carcinoma located between the middle and distal third of the rectum should be treated with peranal anastomosis and the long-term results have to be awaited.