Discussion of: “What happens after a failed LIFT for anal fistula?”

Wright, Moriah; Thorson, Alan G.; Blatchford, Garnet J.; Shashidharan, Maniamparampil; Beaty, Jennifer; Bertelson, Noelle L.; Aggrawal, Piyush; Taylor, Lindsay; Ternent, Charles A.

doi:10.1016/j.amjsurg.2017.10.020

Cited by 2 publications

(1 citation statement)

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“…For example, MAF was used by Podetta et al, in primary operations as well as for secondary ones, regardless of similar rate of recurrences reaching 26.4% and 21.9% after both interventions respectively (14) . In turn, Wright et al, identified 20 (37.7%) patients with recurrence among 53 after primary LIFT, who then underwent loose-seton placement with following either MAF or fistulotomy, resulting in fistula closure in 10 (50%) patients (15) .…”

Section: Discussionmentioning

confidence: 99%

Assessment of Recurrent Anal Fistulas Treatment With Platelet-Rich Plasma

Cwaliński

Hermann

Paszkowski

et al. 2021

Arq. Gastroenterol.

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BACKGROUND: Surgical treatment of recurrent anal fistulas can lead to numerous complications, including fecal incontinence. Therefore, sphincter preserving techniques are gaining more popularity. OBJECTIVE: The aim of the study was to assess effectiveness of platelet-rich plasma (PRP) therapy in the patients with recurrent cryptoglandular anal fistulas. METHODS: A cohort of 18 patients with anal fistulas was enrolled into a preliminary and prospective trial. They were divided into two groups consisting of eight and ten patients respectively. PRP was injected locally in all patients, however in the group II it was applied after 7 days drainage of fistulas with polyurethane foam or negative pressure wound therapy. On average, three doses of PRP were administered, but with the opportunity to double the number of applications if it was clinically justified. The patients were evaluated in an out-patient department after fortnight and then in 1, 6, and 12 months following the last PRP application. RESULTS: Anal fistulas were closed in 4 (50%) patients from the group I and in 7 (70%) patients form the group II. Although, the difference between both groups was not statistically significant, PRP therapy should be preceded with fistulous tract drainage in all patients. Summarizing, that successful result was achieved in 11 (60%) patients from the entire group of 18 participants. CONCLUSION: The rate of recurrent cryptoglandular anal fistulas closure reaching 60%, after topical treatment with PRP, exceeds the results of other sphincter-saving methods of treatment. Therefore, it might become a novel method of anal fistulas therapy.

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Section: Discussionmentioning

confidence: 99%