I Maya, E Spada, M Martí-Gallostra, A Cirera de Tudela, G Pellino, E Espín-Basany
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引用次数: 0
Abstract
Background: Treating complex anal fistulae (CAF) remains a clinical challenge. Regenerative fistula treatment (RFT) with a bioactive matrix enriched with autologous platelet concentrate (Obsidian RFT®) has shown potential in healing CAF while preserving continence, but its long-term efficacy is still debated. This study aims to report the outcomes of RFT in patients with CAF.
Methods: A retrospective analysis of a prospective database of patients with CAF treated with RFT between February 2021 and November 2023 at a single center was conducted. Patients were included if they completed at least a 6-month follow-up. The primary outcome was fistula healing at last available follow-up. Secondary outcomes included unscheduled reoperation and anorectal function.
Results: A total of 31 patients were treated with Obsidian RFT, 17 of whom completed the 6-month follow-up. Nine of the patients were women. The median age was 47 (24-63) years, and eight had inflammatory bowel disease. High transsphincteric fistulae were observed in 52.9% of patients. At a median follow-up of 21.8 (8-36) months, a 53% success rate was achieved. Approximately half of patients required at least one additional procedure owing to CAF persistence or recurrence. There were no reports of morbidity or mortality, and no worsening of continence was observed.
Conclusions: This pilot study demonstrated that nearly half of the patients treated with RFT for CAF achieved long-term healing, with no adverse effects on continence and an excellent safety profile. Larger studies are needed to draw definitive conclusions.
期刊介绍:
Techniques in Coloproctology is an international journal fully devoted to diagnostic and operative procedures carried out in the management of colorectal diseases. Imaging, clinical physiology, laparoscopy, open abdominal surgery and proctoperineology are the main topics covered by the journal. Reviews, original articles, technical notes and short communications with many detailed illustrations render this publication indispensable for coloproctologists and related specialists. Both surgeons and gastroenterologists are represented on the distinguished Editorial Board, together with pathologists, radiologists and basic scientists from all over the world. The journal is strongly recommended to those who wish to be updated on recent developments in the field, and improve the standards of their work.
Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1965 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted. Reports of animal experiments must state that the Principles of Laboratory Animal Care (NIH publication no. 86-23 revised 1985) were followed as were applicable national laws (e.g. the current version of the German Law on the Protection of Animals). The Editor-in-Chief reserves the right to reject manuscripts that do not comply with the above-mentioned requirements. Authors will be held responsible for false statements or for failure to fulfill such requirements.