What is the role of local injections in the treatment of anal fistulas associated with Crohn's disease?

Updated: Nov 09, 2018
  • Author: Bruce M Lo, MD, MBA, CPE, RDMS, FACEP, FAAEM, FACHE; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Answer

In an open-label, single-arm clinical study by de la Portilla et al, local injections of expanded adipose-derived allogeneic mesenchymal stem cells proved beneficial for patients with perianal fistulas associated with Crohn disease. [22] The study involved 24 patients, with investigators finding that in 69.2% of cases, the number of draining fistulas was reduced, while in 56.3% of patients, the treated fissures closed completely, and in 30% of cases, all existing fistula tracts completely closed. [22]

A systematic review of the literature concluded that the advancement flap technique to treat anal fistulas in patients with Crohn disease is an adequate alternative management option. [23]


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