The impact of plasma-rich platelet injection to perianal sphincters on incontinence and quality of life in patients with rectal cancer after low anterior or intersphincteric resection: a prospective cohort study

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dc.authorid0000-0001-8500-7276
dc.authorid0000-0002-1309-6588
dc.authorid0000-0002-5263-3753
dc.authorid0000-0002-3386-1734
dc.authorid0009-0009-4853-8794
dc.authorid0000-0003-2357-5387
dc.contributor.authorHaksal, Mustafa Celalettin
dc.contributor.authorAkın, Mustafa Salih
dc.contributor.authorKaragöz, Emre
dc.contributor.authorKoçak, Mehmet
dc.contributor.authorKorkut, Emin
dc.contributor.authorHosseini, Reza Shah
dc.contributor.authorGöğenur, İsmail
dc.contributor.authorÖncel, Mustafa
dc.date.accessioned2024-09-24T06:25:18Z
dc.date.available2024-09-24T06:25:18Z
dc.date.issued2024
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Genel Cerrahi Ana Bilim Dalı
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, İç Hastalıkları Ana Bilim Dalı
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Temel Tıp Bilimleri Bölümü, Biyoistatistik ve Tıp Bilişimi Ana Bilim Dalı
dc.description.abstractBackground: Incontinence is not rare after rectal cancer surgery. Platelet-rich plasma may promote tissue repair and generation but has never been tested for the treatment of anal incontinence. This study evaluated the impact of platelet-rich plasma injection on the severity of incontinence and quality of life after low rectal cancer surgery. Methods: This is a prospective cohort proof of concept study in a colorectal cancer institution. Patients had undergone low anterior or intersphincteric resection for low rectal cancer and had a Wexner score > 4. Ten milliliters of platelet-rich plasma were injected into the internal and external sphincters under endoanal ultrasound (EAUS) guidance. Primary outcome measure was > 2 point improvement in Wexner score (improved group). The patients were assessed with endo-anal ultrasound examination, manometry, the Wexner Questionnaire and SF-36 Health Surveys, and patients were asked whether they used pads and antidiarrheal medications before and 6 months after PRP injection. Results: Of 20 patients included in the study, 14 (70%) were men, and the average age was 56.8 (SD = 9.5) years. No statistically significant difference was found in Wexner scores before and after PRP injection (p = 0.66). Seven (35%) patients experienced a > 2 point improvement in Wexner score. Rectal manometry demonstrated improved squeezing pressure (p = 0.0096). Furthermore, physical functioning scoring (p = 0.023), role limitation (p = 0.016), emotional well-being (p = 0.0057) and social functioning (p = 0.043) domains on the SF-36 questionnaire improved. One (5%) and three (15%) patients stopped using pads and antidiarrheal medications. Conclusion: Platelet-rich plasma injection does not restore Wexner scores, but more than one-third of patients may benefit from this application with an improvement of > 2 points in their scores. Platelet-rich plasma injection may improve squeezing pressure and certain life quality measures for incontinent patients after rectal cancer surgery.
dc.description.sponsorshipTÜBİTAKen_US
dc.identifier.citationHaksal, M. C., Akın, M. S., Karagöz, E., Koçak, M., Korkut, E., Hosseini, R. S. ... Öncel, M. (2024). The impact of plasma-rich platelet injection to perianal sphincters on incontinence and quality of life in patients with rectal cancer after low anterior or intersphincteric resection: a prospective cohort study. Techniques in Coloproctology, 28(1). http://dx.doi.org/10.1007/s10151-024-02989-1
dc.identifier.doi10.1007/s10151-024-02989-1
dc.identifier.issn1123-6337
dc.identifier.issn1128-045X
dc.identifier.issue1
dc.identifier.pmid39143419
dc.identifier.scopus2-s2.0-85201284645
dc.identifier.scopusqualityQ1
dc.identifier.urihttp://dx.doi.org/10.1007/s10151-024-02989-1
dc.identifier.urihttps://hdl.handle.net/20.500.12511/12829
dc.identifier.volume28
dc.identifier.wos001291744900001en_US
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthorHaksal, Mustafa Celalettin
dc.institutionauthorAkın, Mustafa Salih
dc.institutionauthorKaragöz, Emre
dc.institutionauthorKoçak, Mehmet
dc.institutionauthorKorkut, Emin
dc.institutionauthorHosseini, Reza Shah
dc.institutionauthorÖncel, Mustafa
dc.language.isoen
dc.relation.ispartofTechniques in Coloproctologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsAttribution 4.0 International*
dc.rightsinfo:eu-repo/semantics/openAccess
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/*
dc.subjectIncontinence
dc.subjectIntersphincteric Resection
dc.subjectLow Anterior Resection
dc.subjectPlasma Rich Platelet
dc.subjectRectal Cancer
dc.titleThe impact of plasma-rich platelet injection to perianal sphincters on incontinence and quality of life in patients with rectal cancer after low anterior or intersphincteric resection: a prospective cohort study
dc.typeArticle

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