Functional Outcomes After Turnbull–Cutait Pull-Through Coloanal Anastomosis for Rectal Cancer: A Single-Center Analysis
Rui Ferreira-Santos, João P. Pinho, Mariana Fernandes, Marta Marques, Mariana Martins, Carlos C. Pereira, Sandra Martins, Joaquim C. PereiraAbstract
Background:
The treatment of low rectal cancer (LRC) is challenging. Total mesorectal excision with immediate coloanal anastomosis (CAA) is the gold standard for treating LRC; however, this approach is associated with a high risk of anastomotic leakage. The Turnbull–Cutait (TCA) pull-through procedure offers an alternative, avoiding the creation of a stoma and reducing the risk of anastomotic dehiscence. However, data on its functional outcomes remain scarce.
Objectives:
To compare the functional outcomes of patients undergoing TCA with those undergoing CAA.
Design:
Single-center retrospective study.
Setting:
High-volume referral center.
Patients and Methods:
All patients with LRC who underwent resection with CAA or TCA between January 2019 and December 2023 were included in this study. Functional outcomes were compared between patients undergoing TCA and CAA.
Main Outcome Measures:
Functional outcomes were assessed using the low anterior resection syndrome (LARS) and Wexner Continence scores.
Sample Size:
A total of 33 patients were included.
Results:
Among the study population, 14 (42.4%) underwent TCA and 19 (57.6%) immediate CAA. The median tumor height (5.0 [3.7–6.8] vs. 7.0 [5.0–8.5] cm,
Conclusion:
The TCA pull-through and CAA techniques for LRC presented comparable functional outcomes. TCA was associated with significant decreases in the rates of anastomotic leakage and pelvic sepsis.
Limitations:
Retrospective study design; small sample size.