Bioengineering (Basel, Switzerland) · 2026 · 系統性回顧（依標題推測）
Intraoperative Autologous Adipose-Derived Therapies and PRP as Add-On in the Surgical Treatment of Cryptoglandular and Crohn's Disease-Related Perianal Fistula-A Systematic Review.
其他（運動科學・政策・牙科等） · 克隆氏症
中文閱讀摘要
系統性回顧顯示，術中自體脂肪衍生療法及PRP輔助治療肛瘺癒合率不一，PRP未顯優於標準治療，因異質性高，整體療效證據有限。
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原始摘要
Background
The treatment of perianal fistulas remains challenging, with low healing and high recurrence rates. Autologous adipose-derived regenerative therapies and platelet-rich plasma (PRP) have emerged as adjuncts to surgical intervention for cryptoglandular and Crohn's disease (CD)-related perianal fistulas (PAF). This systematic review evaluates the outcomes of these therapies as an add-on to surgical intervention.
Methods
A systematic search was conducted in several online databases up to December 2025. Studies with ≥10 patients reporting on the use of intraoperative autologous adipose-derived therapies and/or PRP for the treatment of cryptoglandular or CD-related PAF, and clinical healing rates, were included. Other outcomes comprised radiologic healing (as defined in the study), recurrence rates and complications. The study quality was assessed with the Effective Public Health Practice Tool.
Results
In total, 28 studies on individual cases were included ( n = 1017 patients, range 10-219) (17 in cryptoglandular PAF, 8 in CD-related PAF and 3 in both entities). A total of 57% of the studies were rated low quality. In cryptoglandular PAF, reported healing rates with adipose-derived therapies ranged from 50% to 90% across studies of low to good methodological quality. For PRP, three of the four randomized trials demonstrated no superiority over standard care. In CD-related PAF, healing rates after treatment with adipose-derived therapies ranged from 40% to 80%. For PRP, three studies, of which two were low quality, reported highly variable healing rates (33-80%). Radiologic healing, reported in 10 studies, ranged from 38 to 76% in cryptoglandular and 33-75% in CD-related PAF. Recurrence rates remained <17% for adipose-derived therapies and <31% following treatment with PRP. Major complications occurred in <15% of the patients.
Conclusions
High heterogeneity with regard to fistula complexities, outcome definitions and surgical method was observed in the available studies on autologous add-on therapies. This hinders an overall effectiveness analysis. The promising healing rates, low recurrence rates after healing and low complication rates warrant high-quality trials.
至 Europe PMC 閱讀完整來源 ↗ · 擷取日期 2026-10-19
書目、來源與全文狀態
- DOI
- 10.3390/bioengineering13040393
- PMID／PMCID
- 42072188 / PMC13113760
- 作者
- Verweij MM, Uguten M, Bak MTJ, Witjes CDM, de Vries AC, Molendijk I, van Dongen JA, van Ruler O
- 首次發表日期
- 2026-03-28Europe PMC 提供，部分日期可能依年份或月份推定。
- 卷／期／頁碼或文章編號
- 13 ／ 4 ／ 393
- 書目來源與查核日期
- Europe PMC · 2026-10-19僅核對書目欄位與來源連結；不代表已評讀研究品質。
- 全文與授權
- 來源列有免費全文（查核 2026-10-19），未逐篇測試 PDF 下載。 來源授權標示：cc by。
可回溯引用
Verweij MM, Uguten M, Bak MTJ, Witjes CDM, de Vries AC, Molendijk I, van Dongen JA, van Ruler O. Intraoperative Autologous Adipose-Derived Therapies and PRP as Add-On in the Surgical Treatment of Cryptoglandular and Crohn's Disease-Related Perianal Fistula-A Systematic Review. Bioengineering (Basel, Switzerland). 2026;13(4):393. PMID: 42072188. PMCID: PMC13113760. doi:10.3390/bioengineering13040393
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