Long-term efficacy of mesenchymal stem cell treatment for complex perianal fistulas: A systematic review and meta-analysis.

Introduction: Complex perianal fistula, which is characterized by high occurrence and is difficult to treat with current surgical techniques, negatively affects the life quality of patients. Mesenchymal stem cells (MSCs) have emerged as a new innovative therapy in recent years due to their potent anti-inflammatory and immunomodulatory properties. Considering the high recurrence rate of complex perianal fistula, we performed this systematic review and meta-analysis to assess the long-term effects of MSCs on complex perianal fistula.

Material and methods: Trials with MSC treatment for complex perianal fistula were included. Analyses were conducted using Stata software. The Egger test for linear regression and Begg's funnel plot were used.

Results: MSC treatment considerably improved the clinical response of complex perianal fistula at a follow-up of 24 weeks (OR = 1.86, 95% CI: 1.39-2.50), 48 weeks (OR = 2.23, 95% CI: 1.52-3.26), and 96 weeks (OR = 2.08, 95% CI: 1.17-3.68).

Conclusions: MSC therapy has a long-term effect on the clinical response of complex perianal fistula and should be widely promoted not only in adults but also in infants and adolescents; however, more research on this topic is needed.