BMJ Case Reports 2012; doi:10.1136/bcr-2012-006988

Autologous adipose-tissue derived regenerative cells for the treatment of complex cryptoglandular fistula-in-ano: a report of three cases

  1. Pudhupalayam Bhaskar2
  1. 1Department of Colorectal Surgery, University Hospital North Tees, Stockton on Tees, UK
  2. 2Department of Surgery, University Hospital of North Tees, Stockton on Tees, UK
  1. Correspondence to David W Borowski, DWBorowski{at}


The treatment of complex fistulae-in-ano is challenging and often includes a number of operations due to high rates of recurrence. We report the successful treatment of three consecutive patients with long-standing cryptoglandular fistula-in-ano with a novel combination of mucosal advancement flap and adipose-tissue derived regenerative cells (ADRCs) from the stromal vascular fraction (SVF) obtained from a simple lipoaspiration procedure, using Celution technology. There was no operative morbidity; one patient who had a colostomy for faecal diversion has since undergone restoration of bowel continuity. All thee fistulae remain healed at 2–3-year follow-up. Lipofilling of cryptoglandular fistulae-in-ano with ADRC-enhanced lipofilling appears feasible and safe, and may add to the range of procedures that can be used to treat this difficult problem.

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