摘要
BACKGROUND Local mesenchymal stem cell(MSC)therapy for complex perianal fistulas(PFs)has shown considerable promise.But,the long-term safety and efficacy of MSC therapy in complex PFs remain unknown.AIM To explore the long-term effectiveness and safety of local MSC therapy for complex PFs.METHODS Sources included the PubMed,EMBASE,and Cochrane Library databases.A standard meta-analysis was performed using RevMan 5.3.RESULTS After screening,6 studies met the inclusion criteria.MSC therapy was associated with an improved long-term healing rate(HR)compared with the control condition[odds ratio(OR)=2.13;95%confidence interval(95%CI):1.34 to 3.38;P=0.001].Compared with fibrin glue(FG)therapy alone,MSC plus FG therapy was associated with an improved long-term HR(OR=2.30;95%CI:1.21 to 4.36;P=0.01).When magnetic resonance imaging was used to evaluate fistula healing,MSC therapy was found to achieve a higher long-term HR than the control treatment(OR=2.79;95%CI:1.37 to 5.67;P=0.005).There were no significant differences in long-term safety(OR=0.77;95%CI:0.27 to 2.24;P=0.64).CONCLUSION Our study indicated that local MSC therapy promotes long-term and sustained healing of complex PFs and that this method is safe.
