Short-term results of adipose-derived stem cell therapy for the treatment of complex perianal fistula A single center experience.

[BACKGROUND] In this study, we aimed to investigate the early results of the safety and efficacy of adipose-derived stem cells (ADSCs) injection along with the repair of the internal orifice in the recovery of complex perianal fistula.

[METHODS] The study included patients who underwent autologous adipose tissue-derived stemcell injection for complex perianal fistula between December2017 and January2018. The FDA-approved Lipogems® system was used to prepare autologous micro-fragmented adipose stem cells. Demographic characteristics, history of inflammatory bowel disease, fistula type and length of fistula tract determined by endoanal ultrasound, mean operation duration, postoperative complications, and fistula healing of the patients were evaluated. Fistula healing was evaluated on the 30th ,90th days and 9th months.

[RESULTS] A total of 10 patients, with male predominance, were included in our study. The mean age was 47±13.1 and mean BMI was 28.3±4.79. None of the patients had inflammatory bowel disease Based on endoanal ultrasound findings, fistula type was transsphincteric, extrasphincteric and suprasphincteric for 7, 2 and 1 patients, respectively. Calculated length of fistula tract based on ultrasound was 4.45±1.69(2.5-6.4). Mean duration of operation was 45±7 minutes. None of the patients had any treatment related toxicity, however, two patients experienced bruising at the liposuction site. Healing rate in the follow-up of 30-day, 90-day and 9-month was 70%, 80% and 70%, respectively.

[CONCLUSIONS] In addition to surgical treatment in the form of curettage and closure of the fistula tract, autologous micro-fragmented adipose tissue injection is a safe, feasible, and reproducible procedure that can be performed based on the early results in complex anal fistula healing.

[KEY WORDS] Lipogems®, Mesenchymal stem cell, Regenerative medicine, Adipose tissue-derived mesenchymal stem cell.