Clinical profile and outcomes of patients undergoing a Turnbull-Cutait transanal pullthrough procedure with Delayed Coloanal Anastomosis (DCAA) at the Philippine General Hospital.
- Author:
Marc Paul J. Lopez
;
Mayou Martin T. Tampo
;
Manuel Francisco T. Roxas
;
Hermogenes J. Monroy III
- Publication Type:Journal Article
- Keywords:
delayed coloanal anastomosis;
rectal cancer;
rectal reconstruction;
transanal pullthrough;
Turnbull-Cutait
- From:
Philippine Journal of Surgical Specialties
2021;76(1):1-7
- CountryPhilippines
- Language:English
-
Abstract:
RATIONALE/OBJECTIVES:The Turnbull-Cutait transanal pullthrough
procedure with delayed coloanal anastomosis has been widely used
before the advent of intestinal stapling devices. It is a viable option
for rectal reconstruction for benign and malignant conditions, and is
able to maintain intestinal continuity without the use of a temporary
diversion. It has also been used in salvage operations for pelvic
sepsis, failed anastomosis, and tumor recurrence that will otherwise
require a permanent ileostomy. This study will describe the technique,
as well as the outcomes of patients who underwent the procedure.
METHODS:This is a retrospective descriptive study conducted to report
the outcomes of patients who underwent the Turnbull-Cutait transanal
pull-through with delayed coloanal anastomosis at the Philippine
General Hospital from January 2008 to December 2013. Eleven
patients were identified using an institutional retrospective database.
Clinical data and outcomes were collected using a standard form.
RESULTS:Ten of the 11 patients had an unremarkable postoperative
course. One patient had an anastomotic dehiscence. The mean
operative time was 229.9 minutes for the 1st stage and 28.2 minutes
for the second stage, with a mean blood loss of 463.6 cc for both
stages. The mean interval between the two stages was 7.9 days, with
an average postoperative length of stay of 8.27 days. The average
follow-up was 4.5 years. Functional outcomes were acceptable
(average Wexner score 5.63), except for one patient who had an
anastomotic dehiscence. No perioperative mortality was noted.
CONCLUSION:Turnbull-Cutait trans-anal pullthrough procedure with
delayed coloanal anastomosis appears to be a safe procedure. The
study suggests that it is an alternative strategy in rectal cancer in
providing a sphincter-saving surgery, with the establishment of
gastrointestinal continuity, and without the need for a proximal
diversion. Stoma-less surgery has a notable health economic impact
especially in developing countries because it eliminates the costs
associated with the use of stoma appliances.
- Full text:Clinical profile and outcomes of patients.pdf
