Autologous adipose-derived stem cells for the treatment of complex cryptoglandular fistula (systematic review and meta-analysis)

Khryukin RYu, Bragina AS, Anosov IS, Achkasov SI, Vasilyev VS, Tataurshchikova NS, Manturova NE. Autologous adipose-derived stem cells for the treatment of complex cryptoglandular fistula (systematic review and meta-analysis). Plastic Surgery and Aesthetic Medicine. 2025;(2):117‑127. (In Russ., In Engl.)
https://doi.org/10.17116/plast.hirurgia2025021117

Подписка 2026 Пластическая хирургия и эстетическая медицина (Plastic Surgery and Aesthetic Medicine)

Использование инфографики авторами научных работ

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OBJECTIVE

To compare the effectiveness (healing of complex cryptoglandular fistula) and safety (complication rate) of mesenchymal stem cells (MSCs) in combination with filling of fistula with fibrin glue and isolated administration of fibrin glue in patients with complex cryptoglandular fistula.

MATERIAL AND METHODS

A systematic review and meta-analysis included studies devoted to isolated use of fibrin glue and topical use of MSCs combined with fistula filling with fibrin glue for the treatment of patients with complex cryptoglandular fistulas. Meta-analysis included 3 randomized clinical trials and 198 patients.

RESULTS. C

Ryptoglandular fistula healing rate in the MSCs + fibrin glue group in long-term period (12—24 months) was 50-52.4%, in another group — 26.3—37.3% (OR=2.15; 95% CI 1.08—4.29; p=0.03). This confirms the effectiveness of additional administration of MSCs. There were no significant differences in complication rate (abscesses) that indicates safety of technique. Certain factors can affect the results of surgical treatment (method of treatment and washing of fistulous canal, intensive mixing of cell suspension, method of MSC administration and small experience in fistulous canal closure with fibrin glue).

CONCLUSION

Autologous adipose-derived stem cells are effective and safe for complex cryptoglandular fistula. However, significant limitations of meta-analysis make us cautious about the results and require further randomized trials.

Keywords:

mesenchymal stem cells (MSCs)

stem cells

stromal vascular fraction

complex anal fistula

fistula-in-ano

cryptoglandular fistula

Authors:

Khryukin R.Yu.

Ryzhikh National Medical Research Center of Coloproctology

ORCID: 0000-0003-0556-1782

Bragina A.S.

Voronezh Regional Clinical Hospital No. 1

ORCID: 0009-0005-0471-4531

Anosov I.S.

Ryzhikh National Medical Research Center of Coloproctology

ORCID: 0000-0002-9015-2600

Achkasov S.I.

Ryzhikh National Medical Research Center of Coloproctology;
Russian Medical Academy for Continuous Professional Education

ORCID: 0000-0001-9294-5447

Vasilyev V.S.

Institute of Plastic Surgery and Cosmetology

ORCID: 0000-0002-2220-9695

Tataurshchikova N.S.

Institute of Plastic Surgery and Cosmetology

ORCID: 0000-0002-3486-8188

Manturova N.E.

Institute of Plastic Surgery and Cosmetology;
Pirogov Russian National Research Medical University

SPIN RSCI: 5232-0412
Scopus AuthorID: 55461712100
ORCID: 0000-0003-4281-1947

Received:

26.11.2024

Accepted:

20.12.2024

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References:

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