[Surgery of rectal carcinoma (author's transl)]

The absolute number of deaths caused by rectal carcinomas has greatly increased in the FRG within the last 10 years. However in relation to the age of the patients the rate per 100 000 inhabitants did not change. The results of an operative treatment could only be improved slightly because there is still a delay in diagnosis. Despite a high rate of false negative results (34,1%) the hemoccult-test has been used most frequently as a preoperative diagnostic test. Other biochemical parameters could not replace this test. Nowadays orthograde lavage can be considered as the best preoperative treatment of the bowel. As to the comparison of the prognosis after reaction of the rectum or exstirpation, there remains the problem of preselecting the patients. The indication for resection seems to increase by using staplers. New operative techniques for colostomy and its postoperative care after exstirpating the rectum may provide further improvement for the patients. In nonoperable carcinomas a colostomy can be avoided by using cryosurgery in 2/3 of all patients. So far, surgical results could not be improved by early additional chemotherapy.