Long-term Results of Mucosal Advancement Flap Combined With Platelet-rich Plasma for High Cryptoglandular Perianal Fistulas

K.W. Gottgens, W. Vening, S.J. van der Hagen, W.G. van Gemert, R.R. Smeets, L.P. Stassen, C.G. Baeten, S. Breukink

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Abstract

BACKGROUND: The long-term closure rate of high perianal fistulas after treatment remains disappointing. OBJECTIVE: The goal of this study was the long-term closure rate of high cryptoglandular perianal fistulas mucosal advancement flap with platelet-rich plasma. DESIGN: This study retrospective in design. SETTING: This study was conducted at 2 tertiary referral hospitals. PATIENTS: Patients presenting with high cryptoglandular perianal fistulas involving the middle/upper third of sphincter complex were included. INTERVENTIONS: A staged surgical performed; After seton placement, a mucosal advancement flap was platelet-rich plasma. MAIN OUTCOME MEASURES: Recurrence was the main Incontinence was the secondary outcome. RESULTS: We operated on 25 between 2006 and 2012. Thirteen (52%) patients had previous fistula median follow-up period was 27 months. One patient (4.0%) was lost to after 4 months. Freedom from recurrence at 2 years was 0.83 (95% CI, Two of the 4 patients with a recurrence (8%) had a repeated treatment One patient (4.0%) refused another treatment, but agreed to stay in One patient (4.0%) requested a colostomy, resulting in closure of the Complications occurred in 1 patient (4.0%). Incontinence numbers were median Vaizey score of 3.0 out of a maximum of 24. LIMITATIONS: The limited by its retrospective design, lack of preoperative incontinence selection bias, and phone interview follow-up. CONCLUSION: The long-term results of patients with primary and recurrent high cryptoglandular fistulas treated with a seton followed by mucosal advancement flap and platelet-rich plasma show low recurrence, complication, and incontinence Therefore, this technique seems to be a valid option as treatment. preferably randomized controlled studies are needed to further explore surgical technique.
Original languageEnglish
Pages (from-to)223-227
JournalDiseases of the Colon & Rectum
Volume57
Issue number2
DOIs
Publication statusPublished - 1 Jan 2014

Cite this

@article{b429925b71524b369625636d2a342c67,
title = "Long-term Results of Mucosal Advancement Flap Combined With Platelet-rich Plasma for High Cryptoglandular Perianal Fistulas",
abstract = "BACKGROUND: The long-term closure rate of high perianal fistulas after treatment remains disappointing. OBJECTIVE: The goal of this study was the long-term closure rate of high cryptoglandular perianal fistulas mucosal advancement flap with platelet-rich plasma. DESIGN: This study retrospective in design. SETTING: This study was conducted at 2 tertiary referral hospitals. PATIENTS: Patients presenting with high cryptoglandular perianal fistulas involving the middle/upper third of sphincter complex were included. INTERVENTIONS: A staged surgical performed; After seton placement, a mucosal advancement flap was platelet-rich plasma. MAIN OUTCOME MEASURES: Recurrence was the main Incontinence was the secondary outcome. RESULTS: We operated on 25 between 2006 and 2012. Thirteen (52{\%}) patients had previous fistula median follow-up period was 27 months. One patient (4.0{\%}) was lost to after 4 months. Freedom from recurrence at 2 years was 0.83 (95{\%} CI, Two of the 4 patients with a recurrence (8{\%}) had a repeated treatment One patient (4.0{\%}) refused another treatment, but agreed to stay in One patient (4.0{\%}) requested a colostomy, resulting in closure of the Complications occurred in 1 patient (4.0{\%}). Incontinence numbers were median Vaizey score of 3.0 out of a maximum of 24. LIMITATIONS: The limited by its retrospective design, lack of preoperative incontinence selection bias, and phone interview follow-up. CONCLUSION: The long-term results of patients with primary and recurrent high cryptoglandular fistulas treated with a seton followed by mucosal advancement flap and platelet-rich plasma show low recurrence, complication, and incontinence Therefore, this technique seems to be a valid option as treatment. preferably randomized controlled studies are needed to further explore surgical technique.",
author = "K.W. Gottgens and W. Vening and {van der Hagen}, S.J. and {van Gemert}, W.G. and R.R. Smeets and L.P. Stassen and C.G. Baeten and S. Breukink",
year = "2014",
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language = "English",
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pages = "223--227",
journal = "Diseases of the Colon & Rectum",
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Long-term Results of Mucosal Advancement Flap Combined With Platelet-rich Plasma for High Cryptoglandular Perianal Fistulas. / Gottgens, K.W.; Vening, W.; van der Hagen, S.J.; van Gemert, W.G.; Smeets, R.R.; Stassen, L.P.; Baeten, C.G.; Breukink, S.

In: Diseases of the Colon & Rectum, Vol. 57, No. 2, 01.01.2014, p. 223-227.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Long-term Results of Mucosal Advancement Flap Combined With Platelet-rich Plasma for High Cryptoglandular Perianal Fistulas

AU - Gottgens, K.W.

AU - Vening, W.

AU - van der Hagen, S.J.

AU - van Gemert, W.G.

AU - Smeets, R.R.

AU - Stassen, L.P.

AU - Baeten, C.G.

AU - Breukink, S.

PY - 2014/1/1

Y1 - 2014/1/1

N2 - BACKGROUND: The long-term closure rate of high perianal fistulas after treatment remains disappointing. OBJECTIVE: The goal of this study was the long-term closure rate of high cryptoglandular perianal fistulas mucosal advancement flap with platelet-rich plasma. DESIGN: This study retrospective in design. SETTING: This study was conducted at 2 tertiary referral hospitals. PATIENTS: Patients presenting with high cryptoglandular perianal fistulas involving the middle/upper third of sphincter complex were included. INTERVENTIONS: A staged surgical performed; After seton placement, a mucosal advancement flap was platelet-rich plasma. MAIN OUTCOME MEASURES: Recurrence was the main Incontinence was the secondary outcome. RESULTS: We operated on 25 between 2006 and 2012. Thirteen (52%) patients had previous fistula median follow-up period was 27 months. One patient (4.0%) was lost to after 4 months. Freedom from recurrence at 2 years was 0.83 (95% CI, Two of the 4 patients with a recurrence (8%) had a repeated treatment One patient (4.0%) refused another treatment, but agreed to stay in One patient (4.0%) requested a colostomy, resulting in closure of the Complications occurred in 1 patient (4.0%). Incontinence numbers were median Vaizey score of 3.0 out of a maximum of 24. LIMITATIONS: The limited by its retrospective design, lack of preoperative incontinence selection bias, and phone interview follow-up. CONCLUSION: The long-term results of patients with primary and recurrent high cryptoglandular fistulas treated with a seton followed by mucosal advancement flap and platelet-rich plasma show low recurrence, complication, and incontinence Therefore, this technique seems to be a valid option as treatment. preferably randomized controlled studies are needed to further explore surgical technique.

AB - BACKGROUND: The long-term closure rate of high perianal fistulas after treatment remains disappointing. OBJECTIVE: The goal of this study was the long-term closure rate of high cryptoglandular perianal fistulas mucosal advancement flap with platelet-rich plasma. DESIGN: This study retrospective in design. SETTING: This study was conducted at 2 tertiary referral hospitals. PATIENTS: Patients presenting with high cryptoglandular perianal fistulas involving the middle/upper third of sphincter complex were included. INTERVENTIONS: A staged surgical performed; After seton placement, a mucosal advancement flap was platelet-rich plasma. MAIN OUTCOME MEASURES: Recurrence was the main Incontinence was the secondary outcome. RESULTS: We operated on 25 between 2006 and 2012. Thirteen (52%) patients had previous fistula median follow-up period was 27 months. One patient (4.0%) was lost to after 4 months. Freedom from recurrence at 2 years was 0.83 (95% CI, Two of the 4 patients with a recurrence (8%) had a repeated treatment One patient (4.0%) refused another treatment, but agreed to stay in One patient (4.0%) requested a colostomy, resulting in closure of the Complications occurred in 1 patient (4.0%). Incontinence numbers were median Vaizey score of 3.0 out of a maximum of 24. LIMITATIONS: The limited by its retrospective design, lack of preoperative incontinence selection bias, and phone interview follow-up. CONCLUSION: The long-term results of patients with primary and recurrent high cryptoglandular fistulas treated with a seton followed by mucosal advancement flap and platelet-rich plasma show low recurrence, complication, and incontinence Therefore, this technique seems to be a valid option as treatment. preferably randomized controlled studies are needed to further explore surgical technique.

U2 - 10.1097/DCR.0000000000000023

DO - 10.1097/DCR.0000000000000023

M3 - Article

VL - 57

SP - 223

EP - 227

JO - Diseases of the Colon & Rectum

JF - Diseases of the Colon & Rectum

SN - 0012-3706

IS - 2

ER -