The surgery of rectal cancer has seen significant development in recent yea
rs. When there is a multitude of therapeutic options available, it is essen
tial to identify what can be considered a proven standard or, at least, wha
t has to be included in planning a surgical treatment. Therefore, at this p
oint of time a distal resection margin of 2 cm, total mesorectal excision,
en-bloc resection of adherent structures, colonic pouch reconstruction afte
r very deep resections and limitation of local excision to T1/G1 tumors hav
e to be regarded as standards of the surgical strategy.