{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T10:47:14Z","timestamp":1789469234937,"version":"build-2803163510"},"reference-count":67,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,4,9]],"date-time":"2025-04-09T00:00:00Z","timestamp":1744156800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,4,9]],"date-time":"2025-04-09T00:00:00Z","timestamp":1744156800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Tech Coloproctol"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Since anal fistulas can be challenging to treat; numerous innovative treatments have been proposed, including stem cell therapy. This systematic review aimed to assess pooled rates of fistula healing and adverse events associated with stem cell treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this PRISMA-compliant systematic review we searched PubMed and Scopus for observational and randomized studies reporting outcomes of stem cell treatment for anal fistulas. The main outcome measures were successful healing and adverse effects of stem cell therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, 43 studies incorporating 1160 patients (53.6% male) were included. Underlying fistula etiologies were Crohn\u2019s disease (30 studies) and cryptoglandular disease (12 studies). The main origin of stem cells was from adipose tissue (34 studies) or bone marrow (6 studies). The median follow-up duration was 12\u00a0months. The combined overall pooled healing rate was 58.1% (95% confidence interval (CI) 51.5\u201364.7%). The pooled healing rate for Crohn\u2019s fistulas was 60.4% (95% CI 54.7\u201366.2%) with adipose-derived stem cells and 63.6% (95% CI 49.4\u201377.7%) with bone-marrow-derived cells. The pooled healing rate for cryptoglandular fistulas was 53.8% (95% CI 35.5\u201372.2%) with adipose-derived stem cells. The pooled complication rate was 37.3% (95% CI 27.1\u201347.5%). Stem cells were associated with higher odds of anal fistula healing (odds ratio (OR): 1.81,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003) and similar odds of complications (OR: 1,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.986) compared with controls.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Stem cell treatment of anal fistulas was associated with promising results. The healing rate in Crohn\u2019s anal fistulas was higher than in cryptoglandular fistulas. Bone-marrow-derived stem cells were associated with marginally better outcomes than\u00a0were adipose-derived cells. This finding suggests that the autoimmune inflammatory etiology of Crohn\u2019s disease may respond better to autologous myoblasts than does the infectious etiology of cryptoglandular fistulas.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10151-025-03138-y","type":"journal-article","created":{"date-parts":[[2025,4,9]],"date-time":"2025-04-09T17:34:11Z","timestamp":1744220051000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Systematic review and meta-analysis of the efficacy and safety of stem cell treatment of anal fistulas"],"prefix":"10.1007","volume":"29","author":[{"given":"S. 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