title: Anastomotic salvage after rectal cancer resection using the Turnbull-Cutait delayed anastomosis.
abstract: BACKGROUND
  Turnbull-Cutait abdominoperineal pull-through followed by delayed coloanal anastomosis (DCA) was first described in 1961. Studies have described its use for challenging colorectal conditions. We reviewed our experience with Turnbull-Cutait DCA as a salvage procedure for complex failure of colorectal anastomosis.
  
  
  METHODS
  We performed a retrospective cohort study from October 2010 to September 2011, with analysis of postoperative morbidity and mortality.
  
  
  RESULTS
  Seven DCAs were performed for anastomotic complications (3 chronic leaks, 2 rectovaginal fistulas, 1 colovesical fistula, 1 colonic ischemia) following surgery for rectal cancer. Six patients had a diverting ileostomy constructed as part of previous treatment for anastomotic complications before the salvage procedure. No anastomotic leaks were observed. All procedures but 1 were completed successfully. One patient who underwent DCA subsequently required an abdominoperineal resection and a permanent colostomy for postoperative extensive colonic ischemia. No 30-day mortality occurred.
  
  
  CONCLUSIONS
  Salvage Turnbull-Cutait DCA appears to be a safe procedure and could be offered to patients with complex anastomotic complications. This procedure could be added to the surgeon's armamentarium as an alternative to the creation of a permanent stoma.
authors.affiliation: The Division of General Surgery, University of Toronto, Toronto, Ont.
authors.forename: Julie
authors.initials: J
authors.lastname: Hallet
authors.affiliation: The Department of Surgery, Université Laval, Québec, Que., and the Department of Surgery, CHU de Québec (Hôpital Saint-François d'Assise), Québec, Que.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Bouchard
authors.affiliation: The Department of Surgery, Université Laval, Québec, Que., and the Department of Surgery, CHU de Québec (Hôpital Saint-François d'Assise), Québec, Que.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Drolet
authors.affiliation: The Department of Surgery, Université Laval, Québec, Que.
authors.forename: Hélène
authors.initials: H
authors.lastname: Milot
authors.affiliation: The Department of Surgery, Université Laval, Québec, Que.
authors.forename: Emilie
authors.initials: E
authors.lastname: Desrosiers
authors.affiliation: The Department of Surgery, Université Laval, Québec, Que.
authors.forename: Aude
authors.initials: A
authors.lastname: Lebrun
authors.affiliation: The Department of Surgery, Université Laval, Québec, Que., and the Department of Surgery, CHU de Québec (Hôpital Saint-François d'Assise), Québec, Que.
authors.forename: Roger Charles
authors.initials: RC
authors.lastname: Grégoire
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D003106:Colon / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000379:methods*; D004766:Enterostomy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery*; D012004:Rectal Neoplasms / Q000601:surgery*; D012007:Rectum / Q000601:surgery*; D012086:Reoperation / Q000379:methods; D016879:Salvage Therapy / Q000379:methods