Haksal, Mustafa CelalettinAkın, Mustafa SalihKaragöz, EmreKoçak, MehmetKorkut, EminHosseini, Reza ShahGöğenur, İsmailÖncel, Mustafa2024-09-242024-09-242024Haksal, 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/s10151-024-02989-11123-63371128-045Xhttp://dx.doi.org/10.1007/s10151-024-02989-1https://hdl.handle.net/20.500.12511/12829Background: 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.enAttribution 4.0 Internationalinfo:eu-repo/semantics/openAccessIncontinenceIntersphincteric ResectionLow Anterior ResectionPlasma Rich PlateletRectal CancerArticle28110.1007/s10151-024-02989-1Q10012917449000012-s2.0-8520128464539143419Q1