USE OF MESENCHYMAL CELLS IN THE TREATMENT OF A PATIENT WITH MULTI-RECURRENT FISTULA AND SYMPTOMS OF FECAL INCONTINENCE - CASE REPORT

Patient LPMBS, a 41-year-old female, was referred to our service with a history of multi-recurrent anal fistula. She had undergone three surgical procedures, including a conventional fistulotomy with seton placement, which was surgically removed after 30 days, and a ligation of the intersphincteric fistula tract (LIFT) procedure. Additionally, two ileocolonoscopies had been performed to rule out Crohn's disease. The patient reported symptoms of urgency and rest incontinence for gas, as well as soiling due to a “keyhole defect” caused by previous surgeries. Given her complaints, mesenchymal cell therapy was chosen as the treatment approach. The surgical procedure involved collecting material from the abdominal region using appropriate equipment. This material was used both to repair the fistula and to fill the “keyhole defect” that caused her soiling complaints. The patient was discharged one day post-procedure. During outpatient follow-up, complete fistula healing was observed by the third week, alongside improvements in soiling and partial improvement in incontinence, with a reduction of 2 points on the Jorge-Wexner score. Fistula surgery using mesenchymal cells has proven to be a safe option for complex fistula cases, with good cure rates. Discussions are ongoing regarding its use in other conditions, such as anal fissures, Crohn's disease, cicatricial strictures, and as a filling substance. Notably, in this case, the therapy was applied not only for fistula correction but also as a therapeutic mechanism to mitigate the damage from previous procedures, yielding positive results. Thus, in addition to expanding the therapeutic arsenal for complex fistulas, this treatment may hold promise for other conditions.

No conflict of interest has been declared by the author(s).

Publication History

Article published online:
25 April 2025