Rectal Reconstruction Using the Turnbull-Cutait Abdominoperineal Pull-Through Anastomosis: Indications and Outcomes

Rectal reconstruction with abdominoperineal pull-through and immediate anastomosis has been introduced and developed by many surgeons for more than a century. The Turnbull-Cutait abdominoperineal pull-through procedure with delayed anastomosis was originally described in 1961 for the treatment of low rectal cancers. With the advent of stapling devices and better patient selection, this approach has been considered outmoded and has largely been jettisoned from the repertoire of many even expert surgeons who perform colorectal procedures. A primary colorectal or coloanal anastomosis is now the preferred technique in most patients. We believe that this method is deserving of continued consideration under certain circumstances, however, to salvage patients with nonmalignant complex and septic anorectal conditions that might otherwise mandate permanent diversion. This article presents current indications, technical aspects and outcomes of this historical procedure, the Turnbull-Cutait abdominoperineal pull-through anastomosis, and reviews the relevant literature.