Meta-Analysis
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Stem Cells. Aug 26, 2023; 15(8): 866-875
Published online Aug 26, 2023. doi: 10.4252/wjsc.v15.i8.866
Up-to-date meta-analysis of long-term evaluations of mesenchymal stem cell therapy for complex perianal fistula
Fang Cheng, Huang Zhong, Zhong Huang, Zhi Li
Fang Cheng, Division of Gastroenterology, Zigong First People’s Hospital, Zigong 643000, Sichuan Province, China
Fang Cheng, Huang Zhong, Zhong Huang, Zhi Li, Department of Gastroenterology, Zigong First People’s Hospital, Zigong 643000, Sichuan Province, China
Author contributions: Cheng F and Zhong H developed a search strategy for each database and collected the citations; Hong Z and Li Z performed the assessment of study quality and risk of bias, the data extraction and statistical analysis; Cheng F was major contributors in writing the manuscript; and all authors read and approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fang Cheng, Doctor, Division of Gastroenterology, Zigong First People’s Hospital, No. 42 Shangyihao Road, Zigong 643000, Sichuan Province, China. 1072893878@qq.com
Received: May 7, 2023
Peer-review started: May 7, 2023
First decision: June 9, 2023
Revised: June 21, 2023
Accepted: July 19, 2023
Article in press: July 19, 2023
Published online: August 26, 2023
Abstract
BACKGROUND

Local mesenchymal stem cell (MSC) therapy for complex perianal fistulas (PFs) has shown considerable promise. But, the long-term safety and efficacy of MSC therapy in complex PFs remain unknown.

AIM

To explore the long-term effectiveness and safety of local MSC therapy for complex PFs.

METHODS

Sources included the PubMed, EMBASE, and Cochrane Library databases. A standard meta-analysis was performed using RevMan 5.3.

RESULTS

After screening, 6 studies met the inclusion criteria. MSC therapy was associated with an improved long-term healing rate (HR) compared with the control condition [odds ratio (OR) = 2.13; 95% confidence interval (95%CI): 1.34 to 3.38; P = 0.001]. Compared with fibrin glue (FG) therapy alone, MSC plus FG therapy was associated with an improved long-term HR (OR = 2.30; 95%CI: 1.21 to 4.36; P = 0.01). When magnetic resonance imaging was used to evaluate fistula healing, MSC therapy was found to achieve a higher long-term HR than the control treatment (OR = 2.79; 95%CI: 1.37 to 5.67; P = 0.005). There were no significant differences in long-term safety (OR = 0.77; 95%CI: 0.27 to 2.24; P = 0.64).

CONCLUSION

Our study indicated that local MSC therapy promotes long-term and sustained healing of complex PFs and that this method is safe.

Keywords: Complex perianal fistula, Mesenchymal stem cells, Long-term evaluation, Meta-analysis

Core Tip: The long-term safety and efficacy of mesenchymal stem cell (MSC) therapy for complex perianal fistulas (PFs) remain unknown. So, we explored the long-term effectiveness and safety of local MSC therapy for complex PFs. We found that MSC treatment is a safe and effective method that can significantly improve the long-term healing of complex PFs, and this method confers no risk of MSC-related adverse events.