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indexed in Scopus
Year 2012 Vol. 20 No 6
GENERAL AND SPECIAL SURGERY
S.V. SHAKHRAI, YU.M. GAIN, M.YU. GAIN
EXPERIMENTAL JUSTIFICATION AND FIRST CLINICAL EXPERIENCE OF TRANSPLANTATION OF CULTURE OF AUTOLOGICAL ADIPOSE TISSUE MESENCHYMAL STEM CELLS IN COMPLEX SURGICAL TREATMENT OF EXTRA- AND TRANS-SPHINCTER RECTUM FISTULAS
SEE “Belarusian Medical Academy of post-graduate education”, Minsk, The Republic of Belarus
Objectives. To develop the technology of minimally invasive treatment of trans- and extra-sphincter rectum fistulas with the use of semi-conductor laser radiation and transplantation of autological adipose tissue mesenchymal stem cells.
Methods. The way of chronic paraproctitis modeling has been developed in experiment. Morphological changes of pararectal tissue at complex use of the laser radiation with the length of a wave 1056 nanometers and autological adipose tissue mesenchymal stem cells to treat rectum fistulas have been studied. The worked out minimally invasive method of surgical treatment of high rectum fistulas has been applied in 10 patients.
Results. The designed technology includes the pretransplantation stage (biological material intake, extraction, cultivating, proliferation, differentiation of the autological adipose tissue mesenchymal stem cells in the fibroblast direction with the culture selection of stem cells up to 500 thousands units in 1 ml), and the surgical stage with decontamination of the fistulous channel by the laser radiation with wave length 1560 nm, with suturing the internal opening of rectum fistula and transplantation of mesenchymal stem cells culture from adipose tissue in the fistula channel and parafistula space.
In experiment the results have been obtained testifying to high efficacy of the suggested technology with quick fibrous replacement of the fistula lumen and reduction of the inflammatory process in this zone and in parafistula tissues caused by autological mesenchymal stem cells differentiation in the cellular elements of the connective-fibrous layer, their production of biologically active factors that induce regeneration and promote the accelerated organization of the extracellular matrix.
It has been established that technology application in patients with high rectum fistulas of autotransplantation of adipose tissue mesenchymal stem cells differentiated in the fibroblast direction is an effective complex method of their treatment
Conclusions. The first experience of clinical application of the developed technology allows saying that its practical use promotes efficacy increase of surgical treatment as well as expansion of the application sphere of cellular technologies in practical public health services.
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220013, Respublika Belarus, G. Minsk, ul. P. Brovki, d. 3, korp. 3, GUO «Belorusskaya meditsinskaya akademiya poslediplomnogo obrazovaniya», kafedra neotlozhnoy khirurgii s kursom ambulatornoy khirurgii,
Shahray Sergey Vladimirovich
Shakhrai S.V. Candidate of medical sciences, associate professor of the emergency surgery chair of SEE “Belarusian Medical Academy of post-graduate education”.
Gain U.M. Doctor of medical sciences, professor, Vice-rector on scientific research work, professor of the emergency surgery chair of SEE “Belarusian Medical Academy of post-graduate education”.
Gain M.Y. Post-graduate student of the emergency surgery chair of SEE “Belarusian Medical Academy of post-graduate education”.