title: [Post-surgical complications and mortality after two-stage coloanal anastomosis using the Turnbull-Cutait procedure].
abstract: BACKGROUND
  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.
  
  
  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.
authors.affiliation: Universidad de Barcelona, Barcelona, España. sbn.biondo@gmail.com
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Biondo
authors.forename: Loris
authors.initials: L
authors.lastname: Trenti
authors.forename: Eloy
authors.initials: E
authors.lastname: Espín
authors.forename: Ricardo
authors.initials: R
authors.lastname: Frago
authors.forename: Francesc
authors.initials: F
authors.lastname: Vallribera
authors.forename: Luis Miguel
authors.initials: LM
authors.lastname: Jiménez
authors.forename: Ana
authors.initials: A
authors.lastname: Gálvez
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Sánchez
authors.forename: Esther
authors.initials: E
authors.lastname: Kreisler
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000601:surgery*; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods; D003106:Colon / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000401:mortality*; D012189:Retrospective Studies; D055815:Young Adult