Moreno-Serrano Almudena, García-Díaz Juan José, Ferrer-Márquez Manuel, Alarcón-Rodríguez Raquel, Álvarez-García Antonio, Reina-Duarte Ángel
Cirugia General, Hospital La Inmaculada, España.
Cirugia, Hospital Torrecárdenas, España.
Rev Esp Enferm Dig. 2016 Mar;108(3):123-8. doi: 10.17235/reed.2016.3946/2015.
This study aims to demonstrate the effectiveness and safety of autologous fibrin gel rich in platelet growth factors for the treatment of complex perianal fistulas.
Prospective epidemiological study. Patients with complex perianal fistula or perianal fistula mere alteration of continence are included. identification of both holes and the journey, curettage of it and instillation of Vivostat PRF® in the way it is done to observe excess material by OFE. The variables analyzed were: age, sex, use of prior Seton clinic prevalent type of fistula, postoperative complications, fistula closure and impaired quality of life using the SF-36 test (v2).
From January 2011 to May 2013 have involved 23 patients, 12 men and 11 women, with an average age of 49 years and a minimum follow-up of 12 months. Two dropped out. 17 patients had low transsphincteric fistulas, 2 and 2 high transsphincteric intersphincteric with impaired continence. The most common symptom is the discharge. Twelve patients had a loose seton (62%), of which nine cured. Of all the patients we have operated the success rate is 62%. No patient developed incontinence after treatment. Only two reported a worse quality of life after surgery.
This study demonstrates that there is a clear benefit to the use of Vivostat PRF® as a treatment for complex perianal fistulas. It is a highly reproducible technique with acceptable results and does not produce impairment of continence.
本研究旨在证明富含血小板生长因子的自体纤维蛋白凝胶治疗复杂性肛周瘘的有效性和安全性。
前瞻性流行病学研究。纳入患有复杂性肛周瘘或仅存在肛门节制改变的肛周瘘患者。识别瘘管的两个开口及其走行,进行刮除,并按常规方法向其中注入Vivostat PRF®,以便通过OFE观察多余物质。分析的变量包括:年龄、性别、先前是否使用过挂线疗法、瘘管的临床流行类型、术后并发症、瘘管闭合情况以及使用SF - 36测试(v2)评估生活质量受损情况。
2011年1月至2013年5月共纳入23例患者,其中男性12例,女性11例,平均年龄49岁,最短随访12个月。2例退出研究。17例患者为低位经括约肌瘘,2例为高位经括约肌瘘,2例为括约肌间瘘且伴有肛门节制受损。最常见的症状是有分泌物。12例患者使用了松挂线疗法(62%),其中9例治愈。在所有接受手术的患者中,成功率为62%。治疗后无患者出现失禁。只有2例患者术后报告生活质量变差。
本研究表明,使用Vivostat PRF®治疗复杂性肛周瘘有明显益处。这是一种高度可重复的技术,结果可接受,且不会导致肛门节制受损。