The following is a summary of “Turnbull-Cutait Pull-Through Procedure Is an Alternative to Permanent Ostomy in Patients With Complex Pelvic Fistulas,” published in the December 2023 issue of Gastroenterology by Lavryk et al.

Since repair treatments often fail, a lifelong opening is often suggested for people with complicated or recurring rectovaginal fistulas. The Turnbull-Cutait pull-through treatment is a last resort for patients who avoid lifelong fecal transfer. For a study, researchers sought to look at how often complex rectovaginal fistulas heal after the Turnbull-Cutait pull-through surgery and figure out what caused them.

After getting approval from the institutional review board, a study of all the women who had surgery for a rectovaginal fistula between 1993 and 2018 was done. Demographics causes, and results after surgery were looked at for each patient in the colorectal surgery area of a major hospital in the United States.

The study looked at adult women with a rectovaginal fistula who had rectal pull-through surgery. 81 people had colonic pull-through surgery. Of those, 26 had a rectovaginal fistula, were 51 years old on average (range 43–57 years), and had a mean BMI of 28 kg/m². About 4 patients (15%) had a return, while 85% got better.

After the previous anastomotic leak, 93% of the patients got better. 75% of people with a stoma caused by Crohn’s disease got better. With the Kaplan-Meier method, the total chance of return was 8% (95% CI, 0%–8%) in the first six months after surgery and 12% after a year. The Turnbull-Cutait pull-through operation may be the only way to keep the gut continuity and, in 85% of cases, treat rectovaginal fistulas safely.

Source: journals.lww.com/dcrjournal/abstract/2023/12000/turnbull_cutait_pull_through_procedure_is_an.13.aspx