[The mesorectum in surgery of rectal cancer]

47 patients with a carcinoma of the middle and lower third of the rectum, all in tumor stage pT2 and pT3, underwent a low anterior resection with total excision of the mesorectum and preservation of continence. In histological examinations, 27.3% of tumors in stage pT3 N2-N3 showed a descending lymphatic spread in the distal mesorectum. In radical tumor surgery, the size of the distal safety margin in the bowel does not seem to be as decisive as total mesorectum excision. In the case of a rectum carcinoma at stage pT3, a multidirectional lymphatic tumor spread can be expected. In rectum surgery appropriate for this tumor stage, such carcinomas require a total mesorectum excision.