From August 1st 1989 to May 1st 1993, 190 rectal adenomas and 75 carcinomas were locally excised with the TEM technique. The mortality was 0.4%, the rate of complications which required surgical re-intervention was 3% in adenomas and 8% in carcinomas. The final histology of the removed carcinomas revealed 44 pT1, 23 pT2 and eight pT3 stages. In two of the eight re-resected patients with pT1 low-risk tumours, residual primary tumour but no lymph node metastases were found. In contrast to this, three of the eleven re-resected patients with pT2 low-risk tumours had already developed lymph node metastases. After an average follow-up time of 14 months, two recurrences were observed in the group of the only locally treated patients with pT1 low-risk carcinomas. Both underwent a secondary procedure for cure but in late tumour stages. No recurrence was diagnosed so far among the re-resected patients.