SYSTEMATIC REVIEW article
Front. Med.
Sec. Gastroenterology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1627065
This article is part of the Research TopicAntiseptic Potential of Tissue Stem Cell Secretomes in Regenerative MedicineView all articles
Adipose-derived stem cell therapies for complex anal fistula: a systematic review and metaanalysis of randomized controlled trials
Provisionally accepted
- 1Shenzhen Hospital (Futian) of Guangzhou University of Chinese Medicine, Shenzhen, China
- 2Guangzhou University of Chinese Medicine, Guangzhou, China
- 3Other, Shenzhen, China
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Purpose: This study aimed to systematically investigate the efficacy of adipose-derived stem cells (ASCs) in complex anal fistula treatment Methods: This study systematically searched randomized controlled studies on the efficacy of ASCs in treating complex anal fistula published before June 2024 in PubMed, EMBASE, Web of Science, and Cochrane Library. Further, relevant journals were manually searched for relevant references, and two researchers independently performed literature search and screening, data extraction, and bias assessment. Stata version 12.0 was utilized to statistically analyze the healing rate of the anal fistula and the incidence of adverse events.Results: This study involved 1056 patients from five randomized controlled trials, including 561 patients in the treatment group (ASCs/ASCs + fibrin glue) and 495 patients in the control group (fibrin glue/placebo). Meta-analysis revealed better short-and long-term efficacy of adipose mesenchymal stem cell treatment for complex perianal fistulas than in conventional treatment. However, no statistical difference was observed between mid-term and ultra-long-term treatments. Subgroup meta-analysis demonstrated a difference in efficacy between various cell doses. Further, all treatments with different sources of ASCs were superior to conventional quality.This study confirms that Adipose-derived Stem Cells can effectively improve shortterm and long-term (1-year) clinical outcomes in patients with complex perianal fistulas, supporting their potential as a novel therapeutic strategy.
Keywords: Perianal fistula, Adipose-derived mesenchymal stem cell, randomized controlled trial, ASCs (adipose stem cells), systematic review and meta-analysis
Received: 12 May 2025; Accepted: 28 Jul 2025.
Copyright: © 2025 Zou, Xue, Liu, Xia, Chen, Peng and Wu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Wenjiang Wu, Shenzhen Hospital (Futian) of Guangzhou University of Chinese Medicine, Shenzhen, China
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