Meta‐analysis of platelet‐rich plasma therapy for anal fistula

Luo, Qinghua; Zhou, Ping; Chang, Shuangqing

doi:10.1111/jocd.14760

Cited by 7 publications

(4 citation statements)

References 20 publications

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“…Despite advancements in surgical techniques, the development of esophageal fistulas remains a significant complication, often requiring innovative therapeutic strategies to achieve favorable outcomes [ 7 ]. PRP has turned out to be a promising adjunctive treatment for our case, demonstrating its potential in promoting tissue repair and wound healing [ 5 , 8 ]. PRP, which was derived from umbilical CB in this instance, contains a concentrated mix of platelets and growth factors that play a crucial role in the healing process [ 6 , 9 ].…”

Section: Discussionmentioning

confidence: 99%

Platelet-rich plasma therapy for postoperative esophageal fistula in a pediatric patient

Di Mitri,

Chiastra,

Collautti

et al. 2024

Journal of Surgical Case Reports

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Postoperative management of esophagocutaneous fistulas in pediatric patients is challenging, often resulting in prolonged hospitalization and increased morbidity. Platelet-rich plasma (PRP) has emerged as a promising adjunctive treatment for such complications. We present the case of a 7-month-old infant who developed an esophago-cutaneous fistula following esophagocoloplasty for esophageal atresia type A. Despite initial conservative management, the fistula persisted, prompting the application of PRP gel derived from umbilical cord blood. After four applications of PRP, complete closure of the fistula was achieved, leading to both functional and aesthetic results. This case highlights the potential of PRP in managing refractory postoperative esophageal fistulas in pediatric patients and underscores the need for further research to optimize treatment protocols and validate its efficacy for this sort of complications

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Section: Discussionmentioning

confidence: 99%

Platelet-rich plasma therapy for postoperative esophageal fistula in a pediatric patient

Di Mitri,

Chiastra,

Collautti

et al. 2024

Journal of Surgical Case Reports

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“…Luo et al. [133] conducted a meta‐analysis of PRP, which included outcomes from six observational case series and three RCTs [Madbouly 2021, Mortagy 2021, Portilla 2019]. The observational case series were limited by heterogenous fistula aetiology (two studies included fistula associated with Crohn's disease), small numbers of study participants, and lack of data on incontinence, fistula healing time and complications [133].…”

Section: Sphincter‐preserving Proceduresmentioning

confidence: 99%

“…The meta‐analysis [133] of the RCTs in PRP [Madbouly 2021, Mortagy 2021, Portilla 2019] did not find a significant improvement in fistula healing with the addition of PRP [100, 134, 135]. The pooled data were limited by the inclusion of heterogenous fistula aetiology, low patient numbers and short follow‐up.…”

Section: Sphincter‐preserving Proceduresmentioning

confidence: 99%

European Society of Coloproctology: Guidelines for diagnosis and treatment of cryptoglandular anal fistula

Reza,

Gottgens,

Kleijnen

et al. 2023

Colorectal Disease

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AimThe primary aim of the European Society of Coloproctology (ESCP) Guideline Development Group (GDG) was to produce high‐quality, evidence‐based guidelines for the management of cryptoglandular anal fistula with input from a multidisciplinary group and using transparent, reproducible methodology.MethodsPreviously published methodology in guideline development by the ESCP has been replicated in this project. The guideline development process followed the requirements of the AGREE‐S tool kit. Six phases can be identified in the methodology. Phase one sets the scope of the guideline, which addresses the diagnostic and therapeutic management of perianal abscess and cryptoglandular anal fistula in adult patients presenting to secondary care. The target population for this guideline are healthcare practitioners in secondary care and patients interested in understanding the clinical evidence available for various surgical interventions for anal fistula. Phase two involved formulation of the GDG. The GDG consisted of 21 coloproctologists, three research fellows, a radiologist and a methodologist. Stakeholders were chosen for their clinical and academic involvement in the management of anal fistula as well as being representative of the geographical variation among the ESCP membership. Five patients were recruited from patient groups to review the draft guideline. These patients attended two virtual meetings to discuss the evidence and suggest amendments. In phase three, patient/population, intervention, comparison and outcomes questions were formulated by the GDG. The GDG ratified 250 questions and chose 45 for inclusion in the guideline. In phase four, critical and important outcomes were confirmed for inclusion. Important outcomes were pain and wound healing. Critical outcomes were fistula healing, fistula recurrence and incontinence. These outcomes formed part of the inclusion criteria for the literature search. In phase five, a literature search was performed of MEDLINE (Ovid), PubMed, Embase (Ovid) and the Cochrane Database of Systematic Reviews by eight teams of the GDG. Data were extracted and submitted for review by the GDG in a draft guideline. The most recent systematic reviews were prioritized for inclusion. Studies published since the most recent systematic review were included in our analysis by conducting a new meta‐analysis using Review manager. In phase six, recommendations were formulated, using grading of recommendations, assessment, development, and evaluations, in three virtual meetings of the GDG.ResultsIn seven sections covering the diagnostic and therapeutic management of perianal abscess and cryptoglandular anal fistula, there are 42 recommendations.ConclusionThis is an up‐to‐date international guideline on the management of cryptoglandular anal fistula using methodology prescribed by the AGREE enterprise.

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“…Furthermore, comparative studies with other new sphincter-saving procedures, such as darvadstrocel (21) or platelet-rich plasma (22), would be helpful to determine the best option for these patients.…”

Section: Discusionmentioning

confidence: 99%

FiLaC� procedure for highly selected anal fistula patients: indications, safety and efficacy from an observational study at a tertiary referral center

Terés¹,

Marcos²,

Santacruz³

et al. 2023

Rev Esp Enferm Dig

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Background: the ideal clinical profile of patients or fistula features for fistula laser closure (FiLaC®) technique remain to be established. The aim of this study was to analyze clinical outcomes and the safety profile of FiLaC® in search for an ideal setting for this technique.Methods: a retrospective observational study was performed from a prospective database including all consecutive patients who underwent surgery for anal fistula (AF) with FiLaC® in the coloproctology unit of a tertiary referral center, between October 2015 and December 2021. The FiLaC® procedure was offered to AF patients who were considered to be at risk of fecal incontinence. Fistulas were described according to Parks' classification and categorized as complex or simple according to the American Gastroenterological Association (AGA) guidelines. Healing was defined by the closure of the internal and external openings for at least six months. Predictive factors of AF healing were investigated.Results: a total of 36 patients were included, with a mean age of 48 ± 13.9 years. Twenty patients (55.6 %) were male and 13 patients (36 %) had Crohn's disease (CD).Fourteen patients (38.8 %) had a complex fistula. The primary and secondary healing rates were 55.6 % and 91.7 %, respectively, during a median follow-up time of 12 months . No fecal continence impairment was registered in any case. The proportion of patients with primary healing was significantly higher in CD patients (76.9 % vs 43.5 %, p = 0.048). Conclusions:FiLaC® is a sphincter-preserving procedure with an excellent safety profile and reasonable success rate despite of the strict patient selection. This technique may be attractive for patients with CD due to its higher primary healing rate.

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Meta‐analysis of platelet‐rich plasma therapy for anal fistula

Cited by 7 publications

References 20 publications

Platelet-rich plasma therapy for postoperative esophageal fistula in a pediatric patient

Platelet-rich plasma therapy for postoperative esophageal fistula in a pediatric patient

European Society of Coloproctology: Guidelines for diagnosis and treatment of cryptoglandular anal fistula

FiLaC� procedure for highly selected anal fistula patients: indications, safety and efficacy from an observational study at a tertiary referral center

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