Abstract
Background: Implantation of the amniotic membrane and their derivatives can have a beneficial effect on tissue repair and regeneration. We report for the first time the implant of an amniotic membrane in a patient affected by cryptoglandular anal fistula. Methods: A patch of human amniotic membrane was implanted in a female patient affected by an anterior transphincteric fistula. Following an accurate curettage of the anal fistula, the cryopreserved amniotic membrane was thawed and then washed in the operating room; one side of the membrane was transfixed with a resorbable suture thus creating an implantable fusiform patch. The membrane was subsequently implanted into the fistula tract from the external to the internal opening. The inner and outer parts of the membrane were then sutured to the internal and external fistula openings. Results: No intraoperative or postoperative complications occurred. The patient was discharged one day after the procedure after an uneventful hospitalization. At the 1-week, 1- and 3-month follow-up visits no pain (VAS 0) was referred by the patient and no inflammation was evident at the level of the previous external fistula opening. Conclusions: The implant of human amniotic membrane in a patient affected by cryptoglandular anal fistula was safely and easily performed. Moreover, future studies to assess the efficacy in the long-term follow-up are needed.
Highlights
Surgical treatment of anal fistulas (AFs) represents an ongoing challenge in proctology [1].The lack of certainty regarding the etiology of AFs could partly clarify the persistence of controversies surrounding this topic
Our previous study confirmed that the expression of cytokines IL-1beta and IL-8 could play a role in the persistence of AFs, and demonstrated the potential importance of the epithelium
The patient was discharged the day after the procedure f an uneventful hospitalization; she suffered no pain
Summary
Surgical treatment of anal fistulas (AFs) represents an ongoing challenge in proctology [1].The lack of certainty regarding the etiology of AFs could partly clarify the persistence of controversies surrounding this topic. Surgical treatment of anal fistulas (AFs) represents an ongoing challenge in proctology [1]. Our previous study confirmed that the expression of cytokines IL-1beta and IL-8 could play a role in the persistence of AFs, and demonstrated the potential importance of the epithelium–. We report for the first time the implant of an amniotic membrane in a patient affected by cryptoglandular anal fistula. Methods: A patch of human amniotic membrane was implanted in a female patient affected by an anterior transphincteric fistula. Following an accurate curettage of the anal fistula, the cryopreserved amniotic membrane was thawed and washed in the operating room; one side of the membrane was transfixed with a resorbable suture creating an implantable fusiform patch. The membrane was subsequently implanted into the fistula tract from the external to the internal opening. At the 1-week, 1- and 3-month follow-up visits no pain (VAS 0)
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