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Short stump and High anastomosis Pull-through (SHiP) procedure: an evolution of the Turnbull-Cutait technique

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The main objective of this session is to talk about the recent interest in the Short stump and High anastomosis Pull-through (SHiP) procedure that encompasses the evolution of the Turnbull-Cutait technique. As many surgeons know, this technique is performed to treat patients with ultra-lower rectal cancer. 

Despite advances in coloanal anastomosis techniques, the number of adequate procedures without complications still falls behind. When it comes to 'Short stump and High anastomosis Pull-through' (SHiP), it is a procedure for Delayed Coloanal Anastomosis without a stoma.

Some years ago, surgeons started to use the Delayed Coloanal Anastomosis technique because the recurring issue was the need to cover and protect this anastomosis with a protective stoma. When it comes to improving results using the Delayed Colon Anastomosis method, the main consideration is fully understanding what the drawbacks of this technique are. 

During the session, audience members raise concerns about initiating this procedure during the retroscopy or during the colonoscopy. In addition, Dr. Bianco also talks about whether patients suffered any postoperative complications such as LARS and at which level.

Dr. Francesco Bianco is currently the president of the Italian Society of Colorectal Surgery (SICCR). 

He is consultant of the division of general, colorectal and oncological surgery and of the emergency surgery unit of the S Leonardo hospital - ASL Naples 3 south in Italy. He is the chief of the surgical oncology department including national screening programs (colorectal, breast and cervical cancer), endoscopy units and the oncological surgeries for the national health service Naples 3 south area (1.1 million inhabitants). Previously, he was chief of the surgical unit for treatment of patients of the third level of colorectal cancer screening program at the National Cancer Institute of Naples "G. Pascale".

From 2011 to 2015 he was a member of the steering committee of the regional government for the development of public screening programs and multidisciplinary pathways for colorectal cancer. He is a tutor of the network of the post-graduate school of surgery of the “Federico II” University of Naples.

In 2020-21 he was reviewer of the guidelines on rectal cancer of the Italian Society of Medical Oncology (AIOM). In 2020 he takes part as one of the three centres that published the first international multicentre randomized trial on Turnbull-Cutait pull-through procedure for delayed coloanal anastomosis for low rectal cancer (Jama Surg). Since 2011 he focused his activity on the treatment of ultra-low rectal cancer and published several manuscripts and videos on the technical evolution of delayed coloanal anastomosis by pull-through (SHiP procedure: Colorectal Dis, Update Surg, Tech Coloproctol, DCR). In 2017 he published the RELAPe trial, the first international multicentre randomized trial on ELAPE procedure for extended ultra-low rectal cancer at State University of New York, Stony Brook, USA (Colorect Dis).  In 2015 he is author of the guidelines for early colon and rectal cancer for the Italian society of colorectal surgery (SICCR).

He is the author of more than a hundred peer-reviewed publications and conference communications and of 10 chapters of books on colorectal topics. 

In 2018-19 he was national coordinator of the treatment and follow-up section of the Italian Group for Colorectal Screening (GISCoR). He is a member and of the European Society of Colo-Proctology (ESCP) and of the European Society of Surgical Oncology (ESSO). 

Currently his main scientific and professional interest is colorectal cancer, minimally invasive surgery, multidisciplinary oncological pathways and colorectal cancer screening.