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In Seob Jeong 2 Articles
Anorectal benign disease
Cell-assisted lipotransfer in treating uncontrollable sepsis associated perianal fistula: a pilot study
In Seob Jeong, Sung Hwan Hwang, Hye Mi Yu, Hyeonseok Jeong
Ann Coloproctol. 2024;40(2):169-175.   Published online February 6, 2023
DOI: https://doi.org/10.3393/ac.2022.00486.0069
  • 3,002 View
  • 154 Download
  • 1 Web of Science
  • 1 Citations
AbstractAbstract PDF
Purpose
Surgeons can treat debilitating conditions of uncontrollable complex anorectal fistulas with sepsis, even after repeated fistula surgeries, for curative intention. Adipose-derived stem cells have shown good outcomes for refractory Crohn fistula. Unfortunately, cell therapy has some limitations, including high costs. We have therefore attempted immediate cell-assisted lipotransfer (CAL) in treating refractory complex anal fistulas and observed its outcomes.
Methods
In a retrospective study, CAL, using a mixture of freshly extracted autologous stromal vascular fraction (SVF) and fat tissues, was used to treat 22 patients of refractory complex anal fistula from March 2018 to May 2021. Preoperative and postoperative assessments were performed with direct visual inspection, digital palpation, and endoanal ultrasonography. A fistula was considered completely healed if (1) the patient had no symptoms of discharge or inflammation; (2) there were no visible secondary openings of fistula tract inside and outside of the anorectal unit and even in the perineum; and (3) there was no primary opening in the anus. The endpoint of complete remission was wound healing without signs of inflammation 3 months after CAL treatment.
Results
In a total of 22 patients who received CAL treatment, 19 patients showed complete remission, 1 patient showed partial improvement, and 2 patients showed no improvement. One of the 2 patients without improvement at primary endpoint showed complete remission 9 months after CAL. There were no significant adverse effects of the procedure.
Conclusion
We found that the immediately-collected CAL procedure for refractory complex anal fistula showed good outcomes without adverse side effects. It can be strongly recommended as an alternative surgical option for the treatment of complex anal fistula that is uncontrollable even after repeated surgical procedures. However, considering the unpredictable characteristics of SVF, long-term follow-up is necessary.

Citations

Citations to this article as recorded by  
  • Tissue engineering and regenerative medicine approaches in colorectal surgery
    Bigyan B. Mainali, James J. Yoo, Mitchell R. Ladd
    Annals of Coloproctology.2024; 40(4): 336.     CrossRef
Effectiveness of Autologous Fat Graft in Treating Fecal Incontinence
Hyeonseok Jeong, Sung Hwan Hwang, Hyoung Rae Kim, Kil O Ryu, Jiyong Lim, Hye Mi Yu, Jihoon Yoon, Chee Young Kim, Kwang-Yong Jeong, Young Jae Jung, In Seob Jeong, Young Gil Choi
Ann Coloproctol. 2019;35(3):144-151.   Published online June 30, 2019
DOI: https://doi.org/10.3393/ac.2018.09.15
  • 6,273 View
  • 97 Download
  • 4 Web of Science
  • 5 Citations
AbstractAbstract PDF
Purpose
The most common risk factor for fecal incontinence (FI) is obstetric injury. FI affects 1.4%–18% of adults. Most patients are unaware when they are young, when symptoms appear suddenly and worsen with aging. Autologous fat graft is widely used in cosmetic surgical field and may substitute for injectable bulky agents in treating FI. Authors have done fat graft for past several years. This article reports the effectiveness of the fat graft in treating FI and discusses satisfaction with the procedure.
Methods
Fat was harvested from both lateral thighs using 10-mL Luer-loc syringe. Pure fat was extracted from harvests and mixed with fat, oil, and tumescent through refinement. Fats were injected into upper border of posterior ano-rectal ring, submucosa of anal canal and intersphincteric space. Thirty-five patients with FI were treated with this method from July 2016 to February 2017 in Busan Hangun Hospital. They were 13 male (mean age, 60.8 years) and 22 female patients (mean age, 63.3 years). The Wexner score was checked before procedure. We evaluated outcome in outpatients by asking the patients. For 19 patients we checked the Wexner score after procedure.
Results
Symptom improved in 29 (82.9%), and not improved in 6 (17.1%). In 2 of 6 patients, they felt better than before procedure, although not satisfied. No improvement in 4. Mean Wexner score was 9.7 before procedure. There were no serious complications such as inflammation or fat embolism.
Conclusion
Autologous fat graft can be an effective alternative treatment for FI. It is safe and easy to perform, and cost effective.

Citations

Citations to this article as recorded by  
  • Cell-assisted lipotransfer in treating uncontrollable sepsis associated perianal fistula: a pilot study
    In Seob Jeong, Sung Hwan Hwang, Hye Mi Yu, Hyeonseok Jeong
    Annals of Coloproctology.2024; 40(2): 169.     CrossRef
  • Efficacy of injection of autologous adipose tissue in the treatment of patients with complex and recurrent fistula-in-ano of cryptoglandular origin
    S. Guillaumes, N. J. Hidalgo, I. Bachero, R. Pena, S. T. Nogueira, J. Ardid, M. Pera
    Techniques in Coloproctology.2024;[Epub]     CrossRef
  • Role of Autologous Fat Grafting in the Conservative Treatment of Fecal Incontinence in Children
    Valentina Pinto, Marco Pignatti, Giovanni Parente, Neil Di Salvo, Luca Contu, Mario Lima
    Journal of Clinical Medicine.2023; 12(4): 1258.     CrossRef
  • Clinical and physiological efficacy of the application of autologous fat with platelet rich plasma in treating faecal incontinence
    Elvis Vargas Castillo, Ingrid Melo Amaral, Arisel Domínguez, Sthephfania López, Daniel Chiantera, Mariangela Pérez Paz, Jenils Daniela Coacuto, Andrés Eloy Soto
    Journal of Coloproctology.2020; 40(03): 227.     CrossRef
  • Preliminary Study on the Echo-Assisted Intersphincteric Autologous Microfragmented Adipose Tissue Injection to Control Fecal Incontinence in Children Operated for Anorectal Malformations
    Giovanni Parente, Valentina Pinto, Neil Di Salvo, Simone D’Antonio, Michele Libri, Tommaso Gargano, Vincenzo Davide Catania, Giovanni Ruggeri, Mario Lima
    Children.2020; 7(10): 181.     CrossRef

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