The intensity of postoperative surveillance for rectal cancer varies greatly between institutions, and recommendations in literature are inconsistent [1]. It is still unclear which method of detection will reveal local recurrence before clinical symptoms or markers of advanced growth appear. Lohnert et al. [2] very well summarized the effectiveness of common follow-up schedules. Anamnesis, tumor markers, digital examination and endoscopy have to detect local recurrence and ultrasound of the liver and chest x-ray have to detect distant metastases. Anamnesis can reveal advanced recurrences that produce pain by secondary invasion of the sacral bone or other adjacent organs, stenosis by extended intraluminal growth, compression by extramural masses or bleeding. Because therapy will be palliative in such cases, anamnesis is an insufficient tool for early detection of local recurrence. Digital rectal examination is limited to the distal 8 cm of the anorectum and exclude one-third to two-thirds of all rectal anastomotic regions from follow-up.