their experience with the Turnbull- Cutait abdominoperineal pull- through operation (TCO) [1]. The eponym comes from 2 surgeons (Dr R. Turnbull and Dr D. Cutait) who simultaneously described the tech-nique,… Click to show full abstract
their experience with the Turnbull- Cutait abdominoperineal pull- through operation (TCO) [1]. The eponym comes from 2 surgeons (Dr R. Turnbull and Dr D. Cutait) who simultaneously described the tech-nique, in literature also referred to as delayed coloanal anastomosis (CAA). This is a retrospective study from a prospectively maintained database, and the authors acknowledge inherent types of bias as a limitation of their study. Overall, 81 patients with TCO and 129 patients with immediate coloanal anastomosis were included. The aim was to analyse outcomes of patients who underwent TCO for sal-vaging complicated anorectal and pelvic conditions with hand- sewn immediate CAA. Failure was defined as the creation of either permanent colostomy, permanent ileostomy, or if the diverting loop ileostomy was never reversed. The authors observed TCO success rate at 1, 3 and 5 years to be 79%, 60%, and 51%, respectively, compared to 91%, 81% and 73% after CAA. Although there was a significant difference in indications, there were no differences in postopera-tive complications. This has also been shown in a cohort of patients undergoing primary delayed CAA for rectal cancer [2]. Moreover, a recent meta- analysis showed that there were no differences in post-operative complications when comparing delayed CAA with immediate CAA [3], but another meta- analysis showed that pelvic sepsis rate was significantly lower in the group of patients who underwent delayed CAA (7% vs.
               
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