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Efficacy analysis of the Turnbull-Cutait procedure in refractory perianal Crohn's disease: a two-centre retrospective
Qianwen Tu1, Huanxin Hu2, Mengting Zhang1
1Department of Colorectal and Anal Surgery, Inflammatory Bowel Disease Surgical Diagnosis and Treatment Center, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China.
Purpose:
Patients with refractory perianal Crohn's disease (RpCD) often face rectal resection and permanent ostomy as a final resort. The Turnbull-Cutait (TC) pull-through procedure offers a potential sphincter-preserving alternative, yet evidence supporting its use in RpCD remains scarce. This study evaluated the therapeutic efficacy of the TC procedure in this setting.
Methods:
A retrospective analysis was conducted on ten patients with RpCD who planned to undergo TC surgery at Zhongnan Hospital of Wuhan University and the Sixth Affiliated Hospital of Sun Yat-sen University from January 2020 to June 2025; ultimately, eight patients completed the surgery. The median follow-up duration was 14.5 months.
Results:
In the per-protocol analysis (n = 8), the incidence of postoperative complications during follow-up was 37.5%, including 1 case of anal fistula recurrence, 1 case of anal incontinence, and 1 case of rectovaginal fistula recurrence. Five patients achieved short-term technical success, yielding a short-term technical success rate of 62.5%. Their median gastrointestinal quality of life index (GIQLI) score was 138 points, indicating an overall high quality of life.
Conclusion:
The TC procedure may serve as a salvage option to avoid permanent stoma in strictly selected patients with RpCD. Although short-term clinical improvement was observed in some patients, the relatively high complication rate and an uncertain long-term efficacy warrant cautious application and careful patient selection.
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