Treatment of Crohn’s disease-related high perianal fistulas combining the mucosa advancement flap with platelet-rich plasma: a pilot study

Göttgens, K. W. A.; Smeets, R.; Stassen, Laurents P. S.; Beets, Geerard L.; Pierik, Marieke; Breukink, Stéphanie O.

doi:10.1007/s10151-015-1311-8

Cited by 41 publications

(30 citation statements)

References 29 publications

(24 reference statements)

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“…The remaining studies (16,17) are to demonstrate the closure of upper perianal fistulas with a technique combining advancement flaps and platelet-rich plasma.…”

Section: Discussionmentioning

confidence: 99%

Using autologous platelet-rich plasma for the treatment of complex fistulas

Moreno-Serrano¹,

García-Díaz²,

Ferrer-Márquez³

et al. 2016

Rev Esp Enferm Dig

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Objective:This study aims to demonstrate the effectiveness and safety of autologous fibrin gel rich in platelet growth factors for the treatment of complex perianal fistulas.Material and methods: Prospective epidemiological study. Patients with complex perianal fistula or perianal fistula mere alteration of continence are included. identification of both holes and the journey, curettage of it and instillation of Vivostat PRF ® in the way it is done to observe excess material by OFE. The variables analyzed were: age, sex, use of prior Seton clinic prevalent type of fistula, postoperative complications, fistula closure and impaired quality of life using the SF-36 test (v2).Results: From January 2011 to May 2013 have involved 23 patients, 12 men and 11 women, with an average age of 49 years and a minimum follow-up of 12 months. Two dropped out. 17 patients had low transsphincteric fistulas, 2 and 2 high transsphincteric intersphincteric with impaired continence. The most common symptom is the discharge. Twelve patients had a loose seton (62%), of which nine cured. Of all the patients we have operated the success rate is 62%. No patient developed incontinence after treatment. Only two reported a worse quality of life after surgery.Conclusion: This study demonstrates that there is a clear benefit to the use of Vivostat PRF ® as a treatment for complex perianal fistulas. It is a highly reproducible technique with acceptable results and does not produce impairment of continence.

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“…The remaining studies (16,17) are to demonstrate the closure of upper perianal fistulas with a technique combining advancement flaps and platelet-rich plasma.…”

Section: Discussionmentioning

confidence: 99%

Using autologous platelet-rich plasma for the treatment of complex fistulas

Moreno-Serrano¹,

García-Díaz²,

Ferrer-Márquez³

et al. 2016

Rev Esp Enferm Dig

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“…A summary of study characteristics is shown in Table 1, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75.…”

Section: Resultsmentioning

confidence: 99%

“…An augmented approach was used in a pilot trial16. This involved placement of a seton, followed by local treatment with platelet‐rich plasma and mucosal advancement flap.…”

Section: Resultsmentioning

confidence: 99%

Systematic review of surgical interventions for Crohn's anal fistula

Lee

Heywood²,

Adegbola

et al. 2017

BJS Open

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BackgroundAnal fistula occurs in approximately one in three patients with Crohn's disease and is typically managed through a multimodal approach. The optimal surgical therapy is not yet clear. The aim of this systematic review was to identify and assess the literature on surgical treatments of Crohn's anal fistula.MethodsA systematic review was conducted that analysed studies relating to surgical treatment of Crohn's anal fistula published on MEDLINE, Embase and Cochrane databases between January 1995 and March 2016. Studies reporting specific outcomes of patients treated for Crohn's anal fistula were included. The primary outcome was fistula healing rate. Bias was assessed using the Cochrane ROBINS‐I and ROB tool as appropriate.ResultsA total of 1628 citations were reviewed. Sixty‐three studies comprising 1584 patients were ultimately selected in the analyses. There was extensive reporting on the use of setons, advancement flaps and fistula plugs. Randomized trials were available only for stem cells and fistula plugs. There was inconsistency in outcome measures across studies, and a high degree of bias was noted.ConclusionData describing surgical intervention for Crohn's anal fistula are heterogeneous with a high degree of bias. There is a clear need for standardization of outcomes and description of study cohorts for better understanding of treatment options.

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“…This study evaluated a small cohort of patients with PCD who were treated with endorectal advancement flaps or MAFs; for patients with ileal pouches, ASCs and PRP yielded satisfactory long‐term outcomes. Although several studies have assessed anorectal fistulas treated with ASCs or PRP , both cryptoglandular and PCD‐associated, this is the first study to combine both techniques added to the creation of an endorectal advancement flap or MAF.…”

Section: Discussionmentioning

confidence: 99%

“…Although several studies have assessed anorectal fistulas treated with ASCs or PRP [9,10,[17][18][19][20][21][22][26][27][28][29][30], both cryptoglandular and PCD-associated, this is the first study to combine both techniques added to Historically, fistulotomy has been the main treatment for transsphincteric fistulas; however, incontinence was a major disadvantage [31]. Therefore, new surgical techniques, such as the MAF, were developed [31].…”

Section: Discussionmentioning

confidence: 99%