Authors' experience with 53 patient operated on for adenocarcinoma of the rectum in Oncologic Surgery Department--University of Messina (Italy) was analysed. The development of mechanical devices has allowed surgeons to perform sphincter-saving in patients with medium-lower tumors of the rectum. In this experience abdominoperineal amputation was performed in cases of distal rectal tumors, local transanal excision was performed in 6 cases. There were no statistically significant differences between low anterior resection and abdomino-perineal resection with respect to local (17% vs 16.6%) and distant (16% vs 16%) recurrence.