Česky
On 29 August 2019, a unique operation was performed at the Hořovice Hospital. A team of specialists injected stem cells into the area of fistulas around the rectum of a 38-year-old patient with Crohn's disease. Fistulas around the rectum are a serious complication of Crohn's disease. In the above patient, it could not be managed by conventional surgical methods, nor by conventional or biological conservative treatment. The unique operation was performed for the first time in the Czech Republic and, apart from its use in clinical research, has been experienced only in seven other countries in the world.
Innovative drug
A drug from the category of somatic-cell therapeutic agents was used in the operation, which contains fatty mesenchymal cells modified to have the ability to heal fistulas. Under general anaesthesia, the patient is injected with the contents of four vials containing thirty million cells per dose into the fistula. Due to the unique properties of the stem cells, the inflammatory reaction at the site of the fistula is reduced and the growth of new tissue is promoted. The majority of treated patients experience healing and closure of the fistula. The team of experts who performed the surgery for the first time in the Czech Republic was led by MUDr. Z. Šerclová from the Hořovice Hospital. "This special operation belongs to the so-called minimally invasive methods, during which we clean the fistula tract, suture the inner mouth of the fistula and inject a drug containing stem cells. In some situations, this is the only way to heal the fistula," comments MUDr. Šerclová.
Fistula: diagnosis and treatment
A perianal fistula is a pathological connection of the rectum with the skin in the area around the anus. Difficulties are manifested by purulent discharge, itching, pain and incontinence. Patients suffer a significant deterioration in quality of life and must undergo repeated acute and elective surgeries. Treatment consists of repeated drains aimed at preventing the formation of painful abscesses and worsening of the disease. It also includes long-term treatment with antibiotics, immunosuppressants and biological therapy. However, these treatments are not able to completely heal the fistula in the long term. Complete surgical removal of fistulas can only be achieved in some cases by relatively complex plastic surgery, which takes many weeks to heal. Thanks to the first administration of stem cells, a new and effective type of treatment is emerging in the Czech Republic.
"We are very pleased that this application of a modern drug containing adipose stem cells could be the first at our institution. This is a new treatment option for a serious and life-limiting complication of Crohn's disease. I see a significant benefit in the minimally invasive nature of the procedure, which can be performed within a one-day hospital stay, and the broadening of the spectrum of fistula treatment," adds MUDr. Šerclová from the Hořovice Hospital, where hundreds of operations for perianal Crohn's disease are performed annually.
