Abstract:

Anal fistula is a colorectal anorectal surgical disease with a high incidence and difficult cure, generally treated by incision or seton procedures, but issues such as long recovery time, high recurrence rate, and poor treatment outcomes exist. In recent years, surgical treatment technologies have continually evolved towards precision, minimization, and regenerative directions. Mesenchymal stem cells (MSCs), recognized for their multipotent differentiation potential and robust paracrine abilities, are acknowledged as ideal for tissue regeneration and repair. Extensive clinical trials of MSCs have proven their safety and efficacy in treating complex, refractory anal fistulas. The current international research on the treatment of anal fistulas with MSCs is still in the exploratory stage. Most studies are small-scale, retrospective, and short-term, leading to a limited understanding of the mechanisms by which MSCs treat anal fistulas. Additionally, there is a diversity of surgical approaches being used, and there is a lack of standardized clinical surgical protocols. This article compiles clinical trial literature from 2003 to 2024 on the treatment of anal fistulas with MSCs, gathered from databases such as PubMed, clinicaltrials.gov, Wanfang, and CNKI. It provides a comprehensive review of domestic and international surgical methods, dosages used, clinical research outcomes, treatment effectiveness, existing challenges, and prospects for development.

Key words: Mesenchymal stem cells, Anal fistulas, Anal canal, Surgical operation