Benign recurrent retrorectal tumours can be safely excised usually without sacrifice of adjacent organs, while en bloc resection is needed for malignant tumours.

QoL recovery following PE was equivalent to that after APR alone. Patients should not be denied exenterative surgery based on perceived poor QoL.

The procedure was deemed to be safe and we include a video to show the operative technique.

CDI should be recognized as a potentially life-threatening complication of ileostomy closure. Careful consideration should be given to peri-operative antibiotic regime, acid suppression, timing of reversal and appropriate preoperative counselling of patients.