Addition of Platelet-Rich Plasma to Endorectal Advancement Flap Repair Does Not Enhance Healing of Cryptoglandular Transsphincteric Fistulas

A retrospective cohort study conducted at a tertiary proctology hospital in the Netherlands evaluated the effectiveness of adding platelet-rich plasma (PRP) to endorectal advancement flap repair in 219 patients with cryptoglandular transsphincteric fistulas. Of these, 88 patients received PRP injections. The study found no significant differences in primary healing (67.0% vs. 69.5%), secondary healing (37.5% vs. 43.5%), or overall healing (73.9% vs. 77.1%) between patients treated with and without PRP. Long-term follow-up data, available for 67.1% of patients, also showed no significant difference in recurrence rates (6.3% vs. 2.9%). Propensity score-weighted analysis confirmed that PRP did not enhance healing outcomes or reduce recurrence rates. The study concludes that PRP does not improve short- or long-term outcomes of endorectal advancement flap repair for these fistulas. Limitations include the retrospective design and reliance on questionnaires for long-term follow-up.