Additional Intraoperative Autologous-Derived Platelet-Rich Stroma to Transanal Flap Repair for the Treatment of Cryptoglandular Transsphincteric Fistulas in a Tertiary Referral Center: Long-Term Outcomes of a Prospective Pilot Study

    January 2025 in “ Bioengineering ”
    Michiel T. Bak, Caroline D.M. Witjes, Roy S. Dwarkasing, Jeanine Arkenbosch, W. R. Schouten, J Veen, Joris A. van Dongen, Gwenny M. Fuhler, C. Janneke van der Woude, Annemarie C. de Vries, Oddeke van Ruler
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    TLDR Combining PRS with TAFR is promising for treating complex fistulas, with most patients achieving long-term healing.
    This prospective pilot study assessed the long-term outcomes of combining intraoperative autologous-derived platelet-rich stroma (PRS) with transanal advancement flap repair (TAFR) in 43 patients with cryptoglandular transsphincteric fistulas. The study found that 77% of patients achieved long-term primary clinical closure, with 94% of these also reaching radiological healing. Recurrence rates were low, with 9% experiencing recurrence after clinical closure and 5% after radiological healing. Unplanned re-interventions were necessary in 12% of cases. The results suggest that PRS with TAFR is a promising treatment for complex fistulas, though further randomized studies are needed to confirm these findings.
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