In 2004 colorectal carcinoma was the most common malignant tumour in Austria, with about 5000 new patients per year. Furthermore, this tumour was responsible for the second largest number cancer deaths behind lung cancer in men and breast cancer in women. About 50% of all colorectal cancers are situated in the rectum . Due to better surgical techniques, improvement and selection for radio- and/or chemotherapy, the rate of local recurrences could be reduced. The aim of this chapter is to highlight the importance of precise knowledge of anatomy and physiology as well as the critical steps in avoiding pitfalls in rectal cancer surgery.
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