Platelet-Rich Plasma in Sphincteroplasty

Document Type : Letter to the Editor

Author

Colorectal Research Center, Shiraz University of Medical Sciences

Abstract

I review the interesting article “Effects of Platelet-Rich Plasma on Healing of Sphincteroplasty: An Experiment in Rabbit Model” (1)about application of Platelet-Rich Plasma in the anal sphincteroplasty
While reviewing the article which proposed a novel idea for improving the outcome of sphincteroplasty three issues were questionable for me:
The first issue is the site of sphincterotomy as it is mentioned located in posterior midline. It is known that the external anal sphincter is connected posteriorly to the anococcygeal ligament posteriorly (2) and division of sphincter in this point is not always associated with separation of sphincter and fecal incontinence.
Animal experiments on the anal sphincter is different in the basis of sphincter function rather than an anatomical basis has a physiologic basis and if sphincterotomy is done in an animal the impaired function should be demonstrated(3) before further intervention. Due to small size of sphincter complex in the small animals it is sometimes hard to understand the exact territory of muscle.

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References

1.            Izadpanah A, Nikzadjamnani H, Safarpour AR, Izadpanah A, Tadayon SMK. Effects of Platelet-Rich Plasma on Healing of Sphincteroplasty: An Experiment in Rabbit Model. Ann Colorectal Res. 2019; 7(3):2-8.
2.            Corman ML, Bergamaschi RCM, Nicholls RJ, Fazio VW. CORMAN’S COLON and RECTAL SURGERY: LIPPINCOTT WILLIAMS & WILKINS; 2013.
3.            Aghaee-afshar M, Rezazadehkermani M, Asadi A, Malekpour-afshar R, Shahesmaeili A, Nematollahi-mahani SN. Potential of Human Umbilical Cord Matrix and Rabbit Bone Marrow–Derived Mesenchymal Stem Cells in Repair of Surgically Incised Rabbit External Anal Sphincter. Dis Colon Rectum. 2009;52(10):1753-61.
4.            Izadpanah A, Rezazadehkermani M, Ghaderi M, Rahimikazerooni S, Safarpour A, Homayounid K, et al. Using amniotic membrane for anal sphincter repair in animal model. j coloproctol. 2016;36(1):40-4
 

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