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International Journal of Colorectal Disease

, Volume 34, Issue 10, pp 1795–1799 | Cite as

Treatment of complex recurrent fistula-in-ano by surgery combined to autologous bone marrow–derived mesenchymal stroma cells and platelet-rich plasma injection

  • Imed Ben Amor
  • Panagiotis LainasEmail author
  • Radwan Kassir
  • Hichem Chenaitia
  • Ibrahim Dagher
  • Jean Gugenheim
Case Report
  • 119 Downloads

Abstract

Purpose

We report a case of successful management of complex recurrent cryptoglandular fistula-in-ano by surgery combined with autologous bone marrow–derived mesenchymal stroma cells (MSCs) and platelet-rich plasma (PRP) injection.

Methods

Clinical, radiological, and surgical data of the patient were reviewed, as well as the current literature on complex fistula-in-ano.

Results

A 37-year-old man with a recurrent cryptoglandular perianal fistula was addressed to our department. Inflammatory bowel disease was excluded by clinical history, endoscopy, and blood tests. Physical examination and MRI showed an anterior external orifice on the midline, 5 cm from the anal verge, with an internal orifice on the same line. Surgery combined to injection of MSC-PRP solution was successfully performed. MSC-PRP solution was prepared while the patient was under general anesthesia: bone marrow MSCs were obtained by centrifugation of a tibial puncture specimen and PRP from a peripheral whole blood sample of the patient. There were no adverse events post-operatively. Clinical and MRI examination 4 months after treatment confirmed the absence of perianal fistula. More than 2 years after surgery, there has been no recurrence.

Conclusions

Treatment of complex recurrent cryptoglandular fistula-in-ano by surgery combined to autologous bone marrow–derived MSCs and PRP injection seems safe in selected patients, allowing long-term healing. This procedure seems promising but further evaluation by clinical trials is warranted.

Keywords

Fistula-in-ano Perianal fistula Mesenchymal stroma cells Platelet-rich plasma 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Imed Ben Amor
    • 1
    • 2
    • 3
  • Panagiotis Lainas
    • 4
    • 5
    Email author
  • Radwan Kassir
    • 6
  • Hichem Chenaitia
    • 7
  • Ibrahim Dagher
    • 4
    • 5
  • Jean Gugenheim
    • 1
    • 2
    • 3
  1. 1.Department of Digestive SurgeryArchet II HospitalNiceFrance
  2. 2.University of Nice-Sophia-AntipolisNiceFrance
  3. 3.INSERM U1081NiceFrance
  4. 4.Department of Minimally Invasive Digestive SurgeryAntoine-Beclere Hospital, AP-HPClamartFrance
  5. 5.Paris-Saclay UniversityOrsayFrance
  6. 6.Department of Digestive SurgeryCHU Felix GuyonSaint-Denis La ReunionFrance
  7. 7.Clinique CitalNiceFrance

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