Original Article
Clinical research of autologous adipose-derived stem cell transplantation in the treatment of complex anal fistulas
Jiang Bin, Shi Hongzhen, Shi Yang, Zhang Sumin, Wang Yehuang, Ni Min, Zhou Chungen, Li Meng, Zhang Yang, Xu Dachao
Published 2019-12-25
Cite as Chin J Colorec Dis (Electronic Edition), 2019,8(6): 566-573. DOI: 10.3877/cma.j.issn.2095-3224.2019.06.005
Abstract
ObjectiveTo evaluate the safety and efficacy of autologous adipose-derived stem cells (ADSCs) in the treatment of complex anal fistulas.
MethodsTwenty-three patients whose age ranged from 12 to 51 years old with complex anal fistula were treated with ADSCs in Colorectal Disease Center of Affiliated Nanjing Hospital of Nanjing University of Chinese Medicine from January 2018 to October 2018. They included 11 patients with Crohn′s disease anal fistulas(CDAF) and 12 patients with cryptoglandular anal fistulas (CPAF). And their clinical data during the follow-up period of 3~12 months were collected. The closure of fistulas were evaluated by clinical evaluation and MRI scan. And the time of complete epithelialization of fistulas were also counted. It shouldn′t be forgotten that Perianal Disease Activity Index (PDAI) should be recorded for patients with CDAF before and after treatment. In addition, anal incontinence score(Wexner score), visual analogue scale score, quality of life score(SF-36) and adverse events were recorded.
ResultsThe total healing rate of fistulas was 69.57%(16/23). The healing rate of CDAF was 90.91% (10/11) and CPAF was 50%(6/12). The average external closure time of 16 patients with fistulas healing was (17.06±4.54) days, of which (17.90±4.53) days was CDAF and (15.67±4.59) days was CPAF. The quality of life score and visual analogue scale come back to preoperative levels in 7 days postoperation, while the anal incontinence score unchanged or decreased. The PDAI of patients with CDAF was (8.55+ 1.37) points before treatment, and (1.27+ 1.10) points 90 days after treatment (t=12.033, P<0.05). No adverse events associated with ADSCs injection were observed in the study.
ConclusionADSCs is a safe and effective treatment for complex anal fistula, especially for CDAF. It can protect the anal function of patients, relieve pain and improve the quality of life during perioperative period.
Key words:
Anal canal; Autologous adipose stem cells; Complex anal fistula; Cryptoglandular anal fistulas; Crohn′s fistula-in-ano; Anal function
Contributor Information
Jiang Bin
Colorectal Disease Center of Affiliated Nanjing Hospital of Nanjing University of Chinese Medicine, Nanjing 210022, China
Shi Hongzhen
Reaserch Institute of Jiangsu Decon Bio-science Technologies Company Ltd., Nanjing 210000, China
Shi Yang
Reaserch Institute of Jiangsu Decon Bio-science Technologies Company Ltd., Nanjing 210000, China
Zhang Sumin
Colorectal Disease Center of Affiliated Nanjing Hospital of Nanjing University of Chinese Medicine, Nanjing 210022, China
Wang Yehuang
Colorectal Disease Center of Affiliated Nanjing Hospital of Nanjing University of Chinese Medicine, Nanjing 210022, China
Ni Min
Colorectal Disease Center of Affiliated Nanjing Hospital of Nanjing University of Chinese Medicine, Nanjing 210022, China
Zhou Chungen
Graduate School of Nanjing University of Chinese Medicine, Nanjing 210029, China
Li Meng
Graduate School of Nanjing University of Chinese Medicine, Nanjing 210029, China
Zhang Yang
Colorectal Disease Center of Affiliated Nanjing Hospital of Nanjing University of Chinese Medicine, Nanjing 210022, China
Xu Dachao
Colorectal Disease Center of Affiliated Nanjing Hospital of Nanjing University of Chinese Medicine, Nanjing 210022, China
