Second redo surgery after two consecutive failures of a colorectal or coloanal anastomosis: is it reasonable?

Colorectal redo surgery is well known to be a difficult procedure, associated with high risk of failure. The aim this study was look into patients presenting two consecutive failed colorectal (CRA) or coloanal (CAA) anastomosis who underwent second (i.e., third anastomosis). A retrospective based on prospective database surgeries CRA CAA, in an expert center. Sixteen between 2005 and 2020 were analyzed. After mean follow-up 28 ± 26 months, success (defined as no stoma at the end follow-up) reported 10/16 (63%). One patient chronic anastomotic leakage another early colonic ischemia had defunctioning reversal. In remaining four surgery, definitive ultimately created for fistula recurrence (n = 1), poor functional results 2), local cancer 1). Two factors failure significantly found univariate analysis: (1) nature primary anastomosis: 3/13 s (23%) if first made 3/3 (100%) it CAA (p 0.036); (2) age: older 0.04). 63% rate observed after CAA. Although demanding can proposed carefully selected motivated patients.