Indroduction: The principle of deciding to preserve the anal sphincter apparatus is due to studies on the meso-rectum in which the need for removal of the rectum due to the suboperitoneal localizations has emerged (!, 2,3,4) thus making the first choice in the treatment of rectal tumors of the supropronitoneal rectum, having the latter an equal biological behavior and leaving only the tumors located in the intraperitoneal rectum that the resection does not include the whole organ. (5,6,7,8). Materials and methods From January 2010 to December 2017 consulted the database of the AOU Polyclinic University of Catania were observed in 37 cases of neoplasia in the seat in the sigmarectum, the patients selected for this analysis had a mean age of 72 years ( range 74-70). Results Interventions with preservation of the sphincters (fig 2) represent 95% of our cases (112 cases) in which both postoperative exitus (20%) occurred. that the local recurrence developed in 14% of the cases associated with 6% (3 paz,) the presence of MTS at a distance. the neolasies of the rectum had a max diameter of between 3-5 cm. Discussion: The modalities of execution of the surgical intervention include the position on the operating bed which is of fundamental importance for the surgeon to have the possibility of maximum accessibility on the operative field with the possibility of varying every type of maneuver in an optimal condition. In the preoperative: the careful evaluation of the extension of the neoplasm beyond the wall of the bowel, the grading 3, the perforation in the tumor area (46.47.48.49). In advanced disease it is necessary to identify patients with limited and resectable disease (50,51,52,53) O With symptomatic disease that with the use of chemotherapy a reduction of the tumor mass is obtained. Or with symptomatic Disease in good general conditions that use sequential therapy with high toxicity in which the therapeutic and fundamental choice. Finally, the multidimensional evaluation in the patient over 70. In which the surgical option can be proposed in a multidisciplinary way (54,55,56) .Conclusion: The rectum colic resection and a surgical intervention that implies a choice of the selection criteria to the intervention, the surgical technique of demolition and reconstruction of complex intestinal continuity and of experience and an oncological radicality, which places the surgeon on a burdensome commitment that the disease proposes is of an environmental and technical social order. . In a society that requires icons of health frenzy (always living, with any illness, and always getting healing), but that does not recognize the merits and the abnegation of these new found heroes, "those who perform an extraordinary and generous act of courage, which involves or may involve the conscious self-sacrifice, in order to protect the good of the health of others.
