Abstract 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.
Tu et al. (2026) studied this question.