The palliative treatment of developed primary or recurrent rectum carcinoma is still an important issue in treatment of this disease. The aim of the surgery is in such case to remove the tumorous obstacle and to prevent the development of ileus, to reduce pain, to limit the volume of tumorous tissue, to prevent bleeding and possible incontinence or mucous secretion. The transanal laser thermodestruction of the tumor represents one of the possible ways of palliative treatment of rectum carcinoma. The method is very considerate even for the high risk patients. On the other hand it requires a short-term hospitalization. The method of transanal laser evaporisation of carcinoma is also important from the ethical point of view: inmany cases itmayprevent the creation of palliative derivative colostomy. This fact is very important especially in patients with the terminal stage of the malign carcinoma because they live the rest of their lives in acceptable conditions. The important benefits are described in three case histories. The method is presented as an urgent surgery in solution of ileus which is based on tumorous rectum stenosis.

        Key words: rectum carcinoma – laser thermodestruction – palliative treatment