Bokelmann D
Langenbecks Arch Chir. 1978 Nov;347:613-7. doi: 10.1007/BF01579403.
Early cancer of the rectum, limited to mucosa and submucosa, can be expected in 11% of all malignant lesions of the rectum. Metastatic spread is found in a high percentage of cases (up to 50%), especially in exulcerated or sessile tumors. Local excision of this lesion is therefore restricted to very few, favorable cases, because the rate of recurrence is high. Low anastomosis after resection shows not only a high rate of recurrence, but also many cases with incomplete or complete anal incontinence. Therefore, radical excision of the rectum with colostomy remains the therapy of choice.