TY - JOUR
T1 - Post-surgical complications and mortality after two-stage coloanal anastomosis using the Turnbull-Cutait procedure
AU - Biondo, Sebastiano
AU - Trenti, Loris
AU - Espín, Eloy
AU - Frago, Ricardo
AU - Vallribera, Francesc
AU - Jiménez, Luis Miguel
AU - Gálvez, Ana
AU - Sánchez, Jose Luis
AU - Kreisler, Esther
PY - 2012/4/1
Y1 - 2012/4/1
N2 - Introduction: As colo-anal anastomoses continue to have a high risk of post-surgical dehiscence it is recommended to combine this with a protective stoma. The main purpose of this study was to determine the post-operative morbidity and mortality rate in patients operated on using the Turnbull-Cutait (T-C) technique with delayed colo-anal anastomosis without a protective ileostomy. Material and methods: An observational study was conducted on 17 patients. The surgical indication was classified as "primary" (group I), and "secondary" (group II) when rescue was performed due to complications in the short to long-term after rectal resection. The surgical technique consisted of two stages: 1) low anterior resection, circumferential mucosectomy from the pectinate line, pulling the colon through the anal canal; 2) resection of the pull-through segment and colo-anal anastomosis between the fifth and tenth day. Demographic data, associated comorbidities, and ASA score were recorded, as well as post-surgical complications, post-surgical mortality, and technical failure (defined as performing a definitive stoma). Results: The review consisted of 13 patients in group I and 4 in group II. Twelve patients were operated on due to rectal cancer, one patient due to a recto-vesico-vaginal fistula, two due to rescue of early complications (from the Emergency Department), and two were operated due to chronic complications after rectal resection. Six patients (35.3%) had one or more complications, three of them required new surgery. There were no postoperative deaths. Conclusions: The T-C could be a first option in cancer of the rectum, with no need for a protective ileostomy. It could be an alternative in urgent re-interventions of patients who have rectal surgery complications. © 2011 AEC.
AB - Introduction: As colo-anal anastomoses continue to have a high risk of post-surgical dehiscence it is recommended to combine this with a protective stoma. The main purpose of this study was to determine the post-operative morbidity and mortality rate in patients operated on using the Turnbull-Cutait (T-C) technique with delayed colo-anal anastomosis without a protective ileostomy. Material and methods: An observational study was conducted on 17 patients. The surgical indication was classified as "primary" (group I), and "secondary" (group II) when rescue was performed due to complications in the short to long-term after rectal resection. The surgical technique consisted of two stages: 1) low anterior resection, circumferential mucosectomy from the pectinate line, pulling the colon through the anal canal; 2) resection of the pull-through segment and colo-anal anastomosis between the fifth and tenth day. Demographic data, associated comorbidities, and ASA score were recorded, as well as post-surgical complications, post-surgical mortality, and technical failure (defined as performing a definitive stoma). Results: The review consisted of 13 patients in group I and 4 in group II. Twelve patients were operated on due to rectal cancer, one patient due to a recto-vesico-vaginal fistula, two due to rescue of early complications (from the Emergency Department), and two were operated due to chronic complications after rectal resection. Six patients (35.3%) had one or more complications, three of them required new surgery. There were no postoperative deaths. Conclusions: The T-C could be a first option in cancer of the rectum, with no need for a protective ileostomy. It could be an alternative in urgent re-interventions of patients who have rectal surgery complications. © 2011 AEC.
KW - Colo-anal anastomosis
KW - Low rectal resection
KW - Turnbull-Cutait procedure
U2 - 10.1016/j.ciresp.2011.12.006
DO - 10.1016/j.ciresp.2011.12.006
M3 - Article
VL - 90
SP - 248
EP - 253
IS - 4
ER -