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Purpose <p>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.</p> Methods <p>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&#xa0;months.</p> Results <p>In the per-protocol analysis (<i>n</i> = 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.</p> Conclusion <p>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.</p>

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Efficacy analysis of the Turnbull–Cutait procedure in refractory perianal Crohn’s disease: a two-centre retrospective study

  • 期刊论文

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  • 发表日期：

    2026年5月14日

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  • Qianwen Tu,
  • Huanxin Hu,
  • Mengting Zhang,
  • Kangcheng Luo,
  • Songlin Wan,
  • Daojiang Li,
  • Yi Li,
  • Jia Ke,
  • Zhao Ding

摘要

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.