Evidence map›Paper›PMID 36063257›Full record

ArticleTechniques in coloproctology2023

Autologous adipose-derived stromal vascular fraction and platelet concentrates for the treatment of complex perianal fistulas.

R Tutino, S Di Franco, M Massani, S Bonventre, G Mazzola, G Lo Re, E Gulotta, L J Kamdem Mambou, G Stassi, G Cocorullo and 1 more

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Techniques in coloproctology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 2 pooled it
2.0field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 2 syntheses or guidelines pooled it, 9 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Review
  5. Article
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 4 institutions in 1 country.

R TutinoDepartment of Surgical, Oncological and Stomatological Disciplines (DI.CHIR.ON.S.), University of Palermo, via Roccaforte, 147, Bagheria, 90011, Palermo, Italy. la.tutino@gmail.com.
S Di Franco *Department of Surgical, Oncological and Stomatological Disciplines (DI.CHIR.ON.S.), University of Palermo, via Roccaforte, 147, Bagheria, 90011, Palermo, Italy. simone.difranco@unipa.it.ORCID 0000-0002-6217-2161
M Massani *Chirurgia 1, Treviso Regional Hospital, AULSS2 Marca Trevigiana, Treviso, Italy.
S BonventreDepartment of Surgical, Oncological and Stomatological Disciplines (DI.CHIR.ON.S.), University of Palermo, via Roccaforte, 147, Bagheria, 90011, Palermo, Italy.
G MazzolaUnit of Transfusion Medicine, University of Palermo, Palermo, Italy.
G Lo ReSection of Radiological Sciences, Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Palermo, Italy.
E GulottaReconstructive Plastic Surgery, ARNAS Ospedali Civico Di Cristina e Benfratelli, Palermo, Italy.
L J Kamdem MambouDepartment of Surgical, Oncological and Stomatological Disciplines (DI.CHIR.ON.S.), University of Palermo, via Roccaforte, 147, Bagheria, 90011, Palermo, Italy.
G StassiDepartment of Surgical, Oncological and Stomatological Disciplines (DI.CHIR.ON.S.), University of Palermo, via Roccaforte, 147, Bagheria, 90011, Palermo, Italy.
G CocorulloDepartment of Surgical, Oncological and Stomatological Disciplines (DI.CHIR.ON.S.), University of Palermo, via Roccaforte, 147, Bagheria, 90011, Palermo, Italy.
G GulottaDepartment of Surgical, Oncological and Stomatological Disciplines (DI.CHIR.ON.S.), University of Palermo, via Roccaforte, 147, Bagheria, 90011, Palermo, Italy.
University of Palermo · ITAzienda di Rilievo Nazionale ed Alta Specializzazione · ITAzienda Ospedaliera Citta' della Salute e della Scienza di Torino · ITCa' Foncello Hospital · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundComplex perianal fistulas are a major challenge for modern surgery since 10-35% of patients have functional problems after treatment. Sphincter-saving techniques have a wide range of efficacy (10-80%). We hypothesised that autologous adipose-derived stromal vascular fraction in combination with platelet rich plasma is a new therapeutic strategy with enhanced cure and function preservation rates.

methodsAdult patients with complex cryptoglandular perianal fistulas were treated with injection of autologous adipose-derived stromal vascular fraction in combination with platelet rich plasma around and inside the fistulous tract between May 2018 and April 2019 at the General and Emergency Surgery Operative Unit of the University Hospital "P. Giaccone" of Palermo. Fistulas were confirmed by magnetic resonance imaging. Patients completed the Short Form-36 score on quality of life and the Wexner and Vaizey scores on faecal incontinence, and they were functionally studied using a three-dimensional anorectal manometry. The clinical and functional follow-up was performed at 1 year and 2 years after surgery.

resultsNine patients (4 males, 5 females; median age 42 years [19-63 years]) with high trans-sphincteric or horseshoe fistulas were treated. The average number of previous surgeries per patient was 4.8. At 1 year follow-up, 77.7% of patients were cured, while at 2 years there was 1case of relapse. The variation in Short Form-36 score in cured patients was not significant (p = 0.0936). No statistically significant differences were found in continence scores.

conclusionsThe proposed treatment is a treatment option that preserves sphincter integrity and function, potentially avoiding postoperative incontinence and the need of repeated treatments.

Indexed as

Cutaneous FistulaRectal FistulaAdipose TissueAdultAnal CanalFemaleHumansInjectionsMaleQuality of LifeTreatment OutcomeCryptoglandularPerianal fistulaPlatelet concentratesStromal cellsSurgery

Identifiers

PMID36063257
PMCPMC9839808
OpenAlexW4294670435

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.