Autologous Platelet-Rich Plasma (a-PRP) treatment for perianal and rectovaginal fistulas: Clinical experience and outcomes in 50 cases
Autores
Constança Marques1,2; Catarina Palma1,2; Carlota Branco1,2; Patrícia Motta Lima1,2; José Assunção Gonçalves1,2. 1 ? Hospital da Luz Lisboa 2 ? Hospital da Luz Oeiras
Resumo Introdução
A-PRP is a sphincter-preserving option for the treatment of perianal and rectovaginal fistulas, that enhances wound healing by the release of various growth factors and cytokines prepared from the centrifugation of the patient?s own blood.
Resumo Métodos
Retrospective analysis of the cohort of patients with perianal and rectovaginal fistulas who underwent surgery with a-PRP between November 2021 and October 2024. The a-PRP was prepared intra-operatively using a syringe-centrifugation-system kit, and injected both into the tissue around the fistula and inside the fistula tract.
Resumo Resultados
50 procedures using a-PRP (n=40 perianal, n=10 rectovaginal fistula), in 44 patients (male/female: 19/25); average age: 45; median BMI: 26. n=9 smokers; n=3 Crohn?s disease; n=4 hidradenitis suppurativa; n=47 prior fistula surgery; n=34: prior seton placement. Median follow-up period: 11,5 months [range: 0-28]. n=16 recurrences (n=4 rectovaginal, n=12 perianal fistula), of which n=6 were reoperated using a-PRP. n=1 recurrence after the second a-PRP. Median period for diagnose of recurrence: 4 months.
Resumo Discussão
A-PRP should be considered an adjuvant option for the treatment of complex and recurrent perianal and rectovaginal fistulas. It uses an autologous substance only, can be repeated and doesn?t compromise the eventual use of other surgical options.