More limited resections are occasionally performed for palliation in patients with distant metastasis. The survival benefits from the no-touch technique and radical lymphadenectomy with high ligation are still controversial.

In rectal cancer, 2 ??is sufficient for the distal resection margin. Several reports have demonstrated improvement in local recurrence rates and cancer-specific survival rate through TME (total mesorectal excision). The technique of chemosensitized irradiation was successful in down staging the tumors and in reducing the tumor size. Preoperative chemoradiation therapy and coloanal anastomosis enables the sphincter-preserving operation more frequently. The rectum, genitourinary structures, and the pelvic autonomic nervous system are very closely related. The urinary and sexual function can be preserved by nerve-sparing operation for rectal cancer. The anorectal function might be improved by colonic pouch operation. Transanal excision or trananal endoscopic microsurgery are advocated for the definitive treatment of small, exophytic, well differentiated, mobile lesions. Resection of hepatic or pulmonary metastasis in cases with-out contraindications improves the survival.