Evidence map›Paper›PMID 37268827›Full record

ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2023

Autologous Fat Grafting: an Emerging Treatment Option for Complex Anal Fistulas.

Estella Y Huang, Beiqun Zhao, Jason Llaneras, Shanglei Liu, Sarah B Stringfield, Benjamin Abbadessa, Nicole E Lopez, Sonia L Ramamoorthy, Lisa A Parry, Amanda A Gosman and 2 more

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

Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
3.2field-weighted citation impact, top 8% 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

8 citing papers in PubMed, 10 citations in OpenAlex.

  1. Trial
  2. Trial
  3. Observational
  4. Review
  5. Review
  6. Article
  7. How to Approach the Difficult Perineum in Crohn's Disease.Clinics in colon and rectal surgery · 2025
    Review
  8. 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

12 authors at 2 institutions in 1 country.

Estella Y HuangDivision of Colon and Rectal Surgery, Department of Surgery, University of California, San Diego, CA, USA.ORCID 0000-0002-6926-0084
Beiqun ZhaoDivision of Colon and Rectal Surgery, Department of Surgery, University of California, San Diego, CA, USA.
Jason LlanerasDivision of Plastic Surgery, Department of Surgery, University of California, San Diego, CA, USA.
Shanglei LiuDivision of Colon and Rectal Surgery, Department of Surgery, University of California, San Diego, CA, USA.
Sarah B StringfieldDivision of Colon and Rectal Surgery, Department of Surgery, Baylor University Medical Center, Dallas, TX, USA.
Benjamin AbbadessaDivision of Colon and Rectal Surgery, Department of Surgery, University of California, San Diego, CA, USA.
Nicole E LopezDivision of Colon and Rectal Surgery, Department of Surgery, University of California, San Diego, CA, USA.
Sonia L RamamoorthyDivision of Colon and Rectal Surgery, Department of Surgery, University of California, San Diego, CA, USA.
Lisa A ParryDivision of Colon and Rectal Surgery, Department of Surgery, University of California, San Diego, CA, USA.
Amanda A GosmanDivision of Plastic Surgery, Department of Surgery, University of California, San Diego, CA, USA.
Marek DobkeDivision of Plastic Surgery, Department of Surgery, University of California, San Diego, CA, USA.
Samuel EisensteinDivision of Colon and Rectal Surgery, Department of Surgery, University of California, San Diego, CA, USA. seisenstein@health.ucsd.edu.
University of California San Diego · USBaylor University Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAutologous fat grafting (AFG) has shown promise in the treatment of complex wounds, with trials reporting good healing rates and safety profile. We aim to investigate the role of AFG in managing complex anorectal fistulas.

methodsThis was a retrospective review of a prospectively maintained IRB-approved database. We examined the rates of symptom improvement, clinical closure of fistula tracts, recurrence, complications, and worsening fecal incontinence. Perianal disease activity index (PDAI) was obtained for patients undergoing combination of AFG and fistula plug treatment.

resultsIn total, 52 unique patients underwent 81 procedures, of which Crohn's was present in 34 (65.4%) patients. The majority of patients previously underwent more common treatments such as endorectal advancement flap or ligation of intersphincteric fistula tract. Fat-harvesting sites and processing technique were selected by the plastic surgeons based on availability of trunk fat deposits. When analyzing patients by their last procedure, 41 (80.4%) experienced symptom improvement, and 29 (64.4%) experienced clinical closure of all fistula tracts. Recurrence rate was 40.4%, and complication rate was 15.4% (7 postoperative abscesses requiring I&D and 1 bleeding episode ligated at bedside). The abdomen was the most common site of lipoaspirate harvest at 63%, but extremities were occasionally used. There were no statistically significant differences in outcomes when comparing single graft treatment to multiple treatments, Crohn's and non-Crohn's, different methods of fat preparation, and diversion.

conclusionAFG is a versatile procedure that can be done in conjunction with other therapies and does not interfere with future treatments if recurrence occurs. It is a promising and affordable method to safely address complex fistulas.

Indexed as

Crohn DiseaseFecal IncontinenceRectal FistulaAdipose TissueAnal CanalHumansInflammationLigationRecurrenceSurgical FlapsTreatment OutcomeAnorectalAutologous fat graftingFistula

Identifiers

PMID37268827
PMCPMC10366023
OpenAlexW4379184631

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.