PMID- 35469036
OWN - NLM
STAT- MEDLINE
DCOM- 20220613
LR  - 20240213
IS  - 1873-4626 (Electronic)
IS  - 1091-255X (Print)
IS  - 1091-255X (Linking)
VI  - 26
IP  - 6
DP  - 2022 Jun
TI  - Ligation of Intersphincteric Fistula Tract (LIFT) with or Without Injection of 
      Bone Marrow Mononuclear Cells in the Treatment of Trans-sphincteric Anal Fistula: 
      a Randomized Controlled Trial.
PG  - 1298-1306
LID - 10.1007/s11605-022-05316-x [doi]
AB  - BACKGROUND: Ligation of intersphincteric fistula tract (LIFT) is a 
      sphincter-saving procedure used for treatment of complex anal fistula. The 
      current study aimed to assess the outcome of local injection of bone marrow 
      mononuclear cells (BM-MNCs) in conjunction with LIFT as compared to LIFT alone in 
      regards to healing rate, time to healing, and ultimate success rate. METHODS: 
      This was a prospective randomized trial on patients with trans-sphincteric anal 
      fistula. Patients were randomly allocated to one of two equal groups: LIFT and 
      LIFT with BM-MNC injection. The main outcome measures were healing at 10 weeks of 
      follow-up, recurrence after healing, and complications. RESULTS: Seventy patients 
      (48 male and 22 female) of a mean age of 37.9 +/- 10.4 years were included. The 
      mean time to complete healing after LIFT + BM-MNCs was significantly shorter than 
      after LIFT alone (20.5 +/- 5.2 vs 28.04 +/- 5.8 days; P < 0.0001). The ultimate 
      success rates of both groups were similar (LIFT = 60% vs LIFT with 
      BM-MNCs = 68.6%, P = 0.62). There was no significant difference in the mean 
      operation time or complication rate between the two groups. Secondary extension 
      and previous anal surgery were significant independent predictors of failure of 
      healing. CONCLUSION: LIFT combined with BM-MNC injection was associated with a 
      shorter time to complete healing than LIFT alone. However, BM-MNC injection did 
      not have a significant impact on the overall healing and ultimate success rate.
CI  - (c) 2022. The Author(s).
FAU - Rezk, Mohamed
AU  - Rezk M
AD  - Colorectal Surgery Unit, General Surgery Department, Mansoura University 
      Hospitals, Mansoura University, 60 El-Gomhouria Street, Mansoura, 35516, 
      Dakahlia, Egypt.
FAU - Emile, Sameh Hany
AU  - Emile SH
AUID- ORCID: 0000-0001-7854-5244
AD  - Colorectal Surgery Unit, General Surgery Department, Mansoura University 
      Hospitals, Mansoura University, 60 El-Gomhouria Street, Mansoura, 35516, 
      Dakahlia, Egypt. sameh200@hotmail.com.
FAU - Fouda, El Yamani
AU  - Fouda EY
AD  - Colorectal Surgery Unit, General Surgery Department, Mansoura University 
      Hospitals, Mansoura University, 60 El-Gomhouria Street, Mansoura, 35516, 
      Dakahlia, Egypt.
FAU - Khaled, Nada
AU  - Khaled N
AD  - Colorectal Surgery Unit, General Surgery Department, Mansoura University 
      Hospitals, Mansoura University, 60 El-Gomhouria Street, Mansoura, 35516, 
      Dakahlia, Egypt.
FAU - Hamed, Mohamed
AU  - Hamed M
AD  - Colorectal Surgery Unit, General Surgery Department, Mansoura University 
      Hospitals, Mansoura University, 60 El-Gomhouria Street, Mansoura, 35516, 
      Dakahlia, Egypt.
FAU - Omar, Waleed
AU  - Omar W
AD  - Colorectal Surgery Unit, General Surgery Department, Mansoura University 
      Hospitals, Mansoura University, 60 El-Gomhouria Street, Mansoura, 35516, 
      Dakahlia, Egypt.
FAU - Khafagy, Wael
AU  - Khafagy W
AD  - Colorectal Surgery Unit, General Surgery Department, Mansoura University 
      Hospitals, Mansoura University, 60 El-Gomhouria Street, Mansoura, 35516, 
      Dakahlia, Egypt.
FAU - AbdelMawla, Ahmed
AU  - AbdelMawla A
AD  - Colorectal Surgery Unit, General Surgery Department, Mansoura University 
      Hospitals, Mansoura University, 60 El-Gomhouria Street, Mansoura, 35516, 
      Dakahlia, Egypt.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20220425
PL  - Netherlands
TA  - J Gastrointest Surg
JT  - Journal of gastrointestinal surgery : official journal of the Society for Surgery 
      of the Alimentary Tract
JID - 9706084
SB  - IM
MH  - Adult
MH  - Anal Canal/surgery
MH  - *Bone Marrow
MH  - Female
MH  - Humans
MH  - Inflammation/etiology
MH  - Ligation/methods
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Recurrence, Local/etiology
MH  - Prospective Studies
MH  - *Rectal Fistula/etiology/surgery
MH  - Recurrence
MH  - Treatment Outcome
PMC - PMC9184453
OTO - NOTNLM
OT  - Anal fistula
OT  - Bone marrow
OT  - LIFT
OT  - Mononuclear cells
OT  - Randomized trial
COIS- The authors declare no competing interests.
EDAT- 2022/04/27 06:00
MHDA- 2022/06/14 06:00
PMCR- 2022/04/25
CRDT- 2022/04/26 05:23
PHST- 2022/01/29 00:00 [received]
PHST- 2022/03/23 00:00 [accepted]
PHST- 2022/04/27 06:00 [pubmed]
PHST- 2022/06/14 06:00 [medline]
PHST- 2022/04/26 05:23 [entrez]
PHST- 2022/04/25 00:00 [pmc-release]
AID - S1091-255X(23)05676-7 [pii]
AID - 5316 [pii]
AID - 10.1007/s11605-022-05316-x [doi]
PST - ppublish
SO  - J Gastrointest Surg. 2022 Jun;26(6):1298-1306. doi: 10.1007/s11605-022-05316-x. 
      Epub 2022 Apr 25.