The use of autologous platelet-rich plasma in the complex treatment of anal fissure combined with anal sphincter spasm in non-hospital settings

Abstract

AIM: to evaluate the clinical efficiency of autologous platelet-rich plasma (PRP) therapy in outpatient treatment of chronic anal fissure combined with anal sphincter spasm. PATIENTS AND METHODS: a comparative study included 480 patients with chronic anal fissure combined with anal sphincter spasm. Before excision of the anal fissure with a radiosurgical scalpel at the first stage of treatment, standard conservative treatment was performed in 220 patients (group I) and PRP therapy was used in 260 patients (group II) by injecting autologous platelet-rich plasma under the scar tissue of the fissure and into the anal sphincter. The tone of the anal sphincter was evaluated by sphincterometry. RESULTS: after surgery, the pain was less intensive in group II than in group I patients, increased tone of anal sphincter was eliminated, quality of life and working capacity were restored, and the period of epithelization of the anal canal wound reduced (29.4 ±2.8 days versus 40.6 ±4.5 days). The recurrence rate decreased from 17.7% to 7.3%. CONCLUSION: the use of PRP therapy in combination with excision of the anal fissure gives good results in 90.4% of patients.