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
ARTICLE HIGHLIGHTS
Research background

An increasing number of studies have indicated that local mesenchymal stem cell (MSC) therapy is safe and efficacious for complex perianal fistulas (PFs). But, the long-term efficacy of MSC therapy is unclear. To date, an increasing number of studies have aimed to perform long-term evaluations of MSC therapy for PFs.

Research motivation

Local MSC therapy for PFs has shown considerable promise. But, the long-term safety and efficacy of MSC therapy in complex PFs is unknown.

Research objectives

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

Research methods

PubMed, EMBASE and Cochrane Library databases were searched that reported the long-term evaluation of local MSC therapy for complex PFs. The effectiveness and safety data analysis were conducted using RevMan5.3.

Research 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).

Research conclusions

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

Research perspectives

In complex PFs treatment, local MSC therapy should be paid more attention to. Considering that this small number may not be enough to represent the whole complex PFs population, In the future, to improve on the quality of research, future studies should be carefully designed and reported.