Autologous Adipose Tissue Injection as Treatment for Ileoanal Pouch-Related Fistulae.

BACKGROUND

Ileal pouch-anal anastomosis (IPAA) is a standard surgical procedure for ulcerative colitis (UC) and familial adenomatous polyposis. However, pouch-related fistulae (PRF) are a significant complication. There is no consensus on the optimal treatment for PRF.

OBJECTIVE

This study evaluated the effectiveness of autologous adipose tissue injection (AATI) as a treatment for PRF.

METHODS

Twenty-one patients with IPAA and a total of 29 PRF were treated with AATI. Patients who did not achieve healing after the first treatment were offered repeated injections. Patients were followed for a median of 16 months after AATI. Outcomes including clinical healing, treatment complications, and recurrence of PRF were registered.

RESULTS

After a single treatment with AATI, 48% of the fistulae were clinically healed. Repeated treatments increased the healing rate to 69%. An additional 14% responded to AATI by reduced secretion from PRF. The procedure was well tolerated with minimal complications.

CONCLUSION

AATI appears to be a safe, minimally invasive, and sphincter-saving treatment for PRF with promising healing rates. Further studies with larger cohorts are necessary to validate these findings.