Introduction: Complex perianal fistula, which is characterized by high occurrence and is difficult to treat with current surgical techniques, negatively affects the life quality of patients. Mesenchymal stem cells (MSCs) have emerged as a new innovative therapy in recent years due to their potent anti-inflammatory and immunomodulatory properties. Considering the high recurrence rate of complex perianal fistula, we performed this systematic review and meta-analysis to assess the long-term effects of MSCs on complex perianal fistula.
Material And Methods: Trials with MSC treatment for complex perianal fistula were included. Analyses were conducted using Stata software. The Egger test for linear regression and Begg's funnel plot were used.
Results: MSC treatment considerably improved the clinical response of complex perianal fistula at a follow-up of 24 weeks (OR = 1.86, 95% CI: 1.39-2.50), 48 weeks (OR = 2.23, 95% CI: 1.52-3.26), and 96 weeks (OR = 2.08, 95% CI: 1.17-3.68).
Conclusions: MSC therapy has a long-term effect on the clinical response of complex perianal fistula and should be widely promoted not only in adults but also in infants and adolescents; however, more research on this topic is needed.
Introduction: Complex perianal fistula, which is characterized by high occurrence and is difficult to treat with current surgical techniques, negatively affects the life quality of patients. Mesenchymal stem cells (MSCs) have emerged as a new innovative therapy in recent years due to their potent anti-inflammatory and immunomodulatory properties. Considering the high recurrence rate of complex perianal fistula, we performed this systematic review and meta-analysis to assess the long-term effects of MSCs on complex perianal fistula.
The perianal abscess is a common emergency surgical presentation. While in most cases simple drainage suffices, occasionally the abscess can track deeply presenting a management challenge. We describe the case of a complex circumferential horseshoe ischioanal abscess with extension below the levator ani through the greater sciatic notch and into the left gluteal region, with the collection involving the intergluteal space and gluteus maximus.
Crohn's disease (CD) is a chronic, complex inflammatory disorder of the gastrointestinal tract that presents significant therapeutic challenges. Despite the availability of a wide range of treatments, many patients experience primary non-response, secondary loss of response, or adverse events, limiting the overall effectiveness of current therapies. Clinical trials often report response rates below 60%, partly due to stringent inclusion criteria.
Full professor at the University of Seville, Department of General and Digestive Surgery, Head of the Coloproctology Unit, Hospital Universitario Virgen del Rocío, Sevilla, Spain.
Introduction: It is a priority to find surgical techniques that guarantee acceptable healing rates without sequelae in the treatment of complex anal fistula. The concept of the deep intersphincteric space as the origin of perianal sepsis has provided a new perspective, allowing the emergence of techniques such as TROPIS (Transanal Opening of Intersphincteric Space), with few published series to date. The aim of this study is to evaluate the healing rate and complications one year after the TROPIS technique as a treatment for complex anal fistula without hospitalization.
Introduction: Crohn's disease (CD) is a chronic inflammatory bowel disease which can affect any area of the gastrointestinal tract, including oral tissues. The complex nature of this disease demands interdisciplinary management, especially when both intestinal and oral manifestations are present.
Case: This report presents the case of a 28-year-old male patient with oral, ileo-caecal and peri-anal CD managed jointly between Gastroenterology and Oral Medicine.
