Evaluation of Autologous Stem Cell Transplantation in Treatment of High and Reccurent Anal Fistula

Abstract

Management of complex perianal fistulas remains a challenge as a consequence of the serious limitations of currently available treatments regarding the problems of faecal incontinence, Mesenchymal adult stem cells extracted from certain tissues, such as bone marrow, can differentiate into various cell types. Therefore, we have tried to use such cells to stimulate healing in complex and recurrent anal fistulae.

We designed a clinical trial, involving 15 patients with complex and recurrent anal fistulae, to test the feasibility and safety of autologous stem cells transplantation in the treatment of fistulae, with evaluation for six months regarding short term post operative complications, healing rate and complete closure of the external opening.

In this study we noticed during the follow up period that the healed \ fistulas were noticed in 8 patients (53.3%) and the mean period of healing was noticed in 97.5 days (3- 4 months post injection) , there were two subgroups of non healing fistulas either incomplete healing which was noticed in 4 patients (26.7%) who reported better quality of life and no other intervention was needed (except for one case) and in the other sub group 3 patients (20%) had no change in the pre and post injection symptoms regarding the continuous discharge (begin serous then tum into pumlent discharge) and were confirmed non healed by means of radiological assessments.

The use of Autologous Stem cells in the treatment of the anal fistula is a recent technique. Despite the rate of failure or incomplete healing but it still provides a solution for the avoidance of continence impairment and extensive tissue scaring which follows the ordinary surgical procedures.