This paper presents the experience of the "Institut Jules Bordet" in the treatment of small carcinomas located in the lower part of the rectum by transanal endoresection. This surgical procedure includes of a total resection of the tumor surrounded by normal tissue. It allows a detailed pathological study of the resected specimens and does not exclude the possibility of either a second surgical resection or an adjuvant radiotherapy. A better knowledge of the rectal cancer prognostic factors and a close cooperation between surgeon and pathologist spare a few patients a permanent colostomy and give them the same hope of cure as the more mutilation radical surgery.