Pull-Through as an anastomotic salvage technique after taTME for low rectal cancer complicated by colon ischemia - a video vignette.

Transanal colonic pull-through for rectal resection, followed by a delayed colo-anal anastomosis, was originally reported in 1961 by Turnbull and Cutait [1, 2]. This procedure was proposed with the aim of reducing anastomotic leakage, pelvic complications and the need for stoma formation. Currently, standard indications are the surgical treatment of Hirschsprung's disease, in the case of hostile pelvis or as a rescue operation after anastomotic leakage in adult rectal cancer [3]. Additionally, it has been proposed as an alternative to prophylactic diverting stoma, for colo-anal reconstruction following middle and low rectal cancer resection [4]. More recently, a modification of the technique (SHiP procedure), using referral stiches to allow a more proximal anastomosis in the anal canal, has also been used in an elective setting [5].