Geropoulos G, Psarras K, Giannis D, Martzivanou EC, Papaioannou M, Kakos CD, Pavlidis ET, Symeonidis N, Koliakos G, Pavlidis TE. Platelet rich plasma effectiveness in bowel anastomoses: A systematic review. World J Gastrointest Surg 2021; 13(12): 1736-1753 [PMID: 35070077 DOI: 10.4240/wjgs.v13.i12.1736]
Corresponding Author of This Article
Dimitrios Giannis, MD, MSc, Doctor, Postdoctoral Fellow, Institute of Health Innovations and Outcomes Research, Feinstein Institutes for Medical Research, 600 Community Drive, Manhasset, NY 11030, United States. dgiannis@northwell.edu
Research Domain of This Article
Surgery
Article-Type of This Article
Systematic Reviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
Georgios Geropoulos, Department of General Surgery, University College London Hospitals, London NW1 2BU, United Kingdom
Georgios Geropoulos, Kyriakos Psarras, Eirini Chrysovalantou Martzivanou, Efstathios Theodoros Pavlidis, Nikolaos Symeonidis, Theodoros Efstathios Pavlidis, Laboratory of Scientific Research and Experimental Surgery, 2nd Propedeutic Department of Surgery, School of Medicine, Aristotle University, Thessaloniki 54642, Greece
Georgios Geropoulos, Christos Dimitrios Kakos, Surgery Working Group, Society of Junior Doctors, Athens 15123, Greece
Dimitrios Giannis, Institute of Health Innovations and Outcomes Research, Feinstein Institutes for Medical Research, Manhasset, NY 11030, United States
Maria Papaioannou, Georgios Koliakos, Laboratory of Biological Chemistry, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
Author contributions: Geropoulos G, Psarras K and Giannis D equally contributed to this study; Geropoulos G, Giannis D and Psarras K designed the research; Papaioanou M, Martzivanou EC and Kakos CD performed the research; Geropoulos G, Giannis D, Psarras K and Papaioanou M wrote the paper; Martzivanou EC, Pavlidis ET and Symeonidis N analyzed the data; Koliakos G and Pavlidis TE supervised the paper; all authors read and approved the final manuscript.
Conflict-of-interest statement: The authors declared no potential conflicts of interest.
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: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dimitrios Giannis, MD, MSc, Doctor, Postdoctoral Fellow, Institute of Health Innovations and Outcomes Research, Feinstein Institutes for Medical Research, 600 Community Drive, Manhasset, NY 11030, United States. dgiannis@northwell.edu
Received: April 19, 2021 Peer-review started: April 19, 2021 First decision: July 27, 2021 Revised: August 11, 2021 Accepted: November 18, 2021 Article in press: November 18, 2021 Published online: December 27, 2021 Processing time: 249 Days and 0.8 Hours
ARTICLE HIGHLIGHTS
Research background
Several applications of platelet rich plasma (PRP) have been reported in the literature. Some examples include maxillofacial, orthopedic and plastic surgery where PRP is considered to improve the wound healing process. PRP is easily extracted from patient’s blood and includes a variety of growth factor that is thought to improve the wound healing process.
Research motivation
Preclinical studies shows that the PRP has a positive impact in the healing process of bowel anastomosis.
Research objectives
The aim of this study is to define the role of PRP in general surgery, especially in procedures involving bowel anastomosis. Therefore, a systematic review of the literature was performed.
Research methods
A systematic literature search was performed in PubMed, EMBASE, and Scopus databases. Animal studies that investigated the effect of PRP on bowel anastomosis were included in our analysis.
Research results
Among the 2407 studies screened, 18 animal studies were finally included in our analysis. An end-to-end bowel anastomosis was performed in all included studies. PRP origin was autologous in 8 studies and homologous in 10 studies. In 13 out of 18 studies PRP was applied topically to the bowel anastomosis. No postoperative complications attributed to PRP application were reported. Common anastomosis related parameters measured among the included studies were the anastomotic bursting pressure, tissue hydroxyproline, collagen deposition and inflammatory cell infiltration. The individual study results in the aforementioned parameters are presented in tables.
Research conclusions
The application of PRP in bowel anastomosis is feasible and seems to be free of any major complications. PRP application compared to control groups did not show any significant changes in the majority of the included studies. However, in the presence of an underlying condition that impairs intestinal wound healing, including peritonitis or chemotherapy, the application of PRP could potentially improve the healing process.
Research perspectives
Although the results of this study support the use of PRP in bowel anastomosis, further research is needed to confirm the safety and effectiveness of PRP on human bowel anastomoses.
