10.04.2025 | Originalien
Improving outcomes of LIFT procedure for treatment of complex transsphincteric fistulas by addition of platelet-rich plasma
A clinical trial
verfasst von: Alimohammad Bananzadeh, Khadije Gorgi, Sara Shojaei-Zarghani, Hamed Ebrahimibagha, Mohammad Ali Nayeri, Adel Zeinalpour, MD
Erschienen in: coloproctology
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Background
A variety of sphincter-sparing procedures have been proposed for treatment of high-type transsphincteric fistulas, with the ligation of the intersphincteric fistula tract (LIFT) procedure being one such approach. This study aims to investigate the outcomes of LIFT alone versus LIFT combined with platelet-rich plasma (PRP) injection.
Methods
This prospective randomized clinical trial assessed the effects of adding PRP to the LIFT procedure compared to LIFT alone for treatment of complex transsphincteric anal fistulas. The trial commenced with 100 patients, who were randomly allocated into two groups: 50 patients in the intervention group underwent LIFT with adjuvant local PRP injection, while 50 patients in the control group underwent LIFT surgery alone.
Results
A total of 40 patients were included in the intervention and 45 patients in the control group. The LIFT procedure alone achieved a primary healing success rate of 77.8%, which increased to 90% with the addition of PRP. Postoperative complications were observed in 13.3% of patients in the LIFT group, significantly more than in the PRP group (P = 0.027). Additionally, patients in the PRP group reported significantly lower perianal pain on the seventh postoperative day (P < 0.001), shorter healing times for intersphincteric incisions (P < 0.001), shorter healing times for the external orifice of the fistula (P < 0.001), and lower Cleveland Clinic Incontinence Scores (CCIS) at 3 months (P = 0.002) compared to the control group.
Conclusion
The combination of LIFT with PRP not only accelerates healing but also reduces recovery time, alleviates postoperative pain, and minimizes the risk of complications.
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