Published online Dec 27, 2021. doi: 10.4240/wjgs.v13.i12.1736
Peer-review started: April 19, 2021
First decision: July 27, 2021
Revised: August 11, 2021
Accepted: November 18, 2021
Article in press: November 18, 2021
Published online: December 27, 2021
Processing time: 249 Days and 0.8 Hours
Anastomotic leak constitutes a major problem in abdominal surgery. Technical insufficiency, topical or systemic factors contribute to disrupted healing of the performed bowel anastomosis and result in anastomosis leakage, with detrimental effects on patient postoperative outcomes. Despite the investigation of several factors and the invention of protective materials, the ideal agent to prevent anastomotic leaks is yet to be determined.
To study the effect of platelet rich plasma (PRP) on the healing of bowel ana
A systematic literature search was performed in PubMed, EMBASE, and Scopus databases to identify studies investigating the effect of PRP application on bowel anastomosis.
Eighteen studies were eligible with a total population of 712 animals including rats (14 studies), rabbits (2 studies) and pigs (2 studies). No postoperative complications were reported following PRP application. Fourteen out of 18 studies reported a statistically significant higher anastomosis bursting pressure in PRP groups compared to control either in healthy animals or animal models with underlying condition or intervention, such as intraperitoneal chemotherapy or peritonitis. Similar results were reported by ten studies in terms of tissue hydroxyproline levels. One study reported significant increase in collagen deposition in PRP groups. PRP application resulted in significantly decreased inflammatory cell infiltration in the presence of peritonitis or intraperitoneal chemotherapy (6 studies).
The application of PRP is associated with improved bowel anastomosis outcomes, especially in animal models having an underlying condition affecting the normal healing process. PRP application seems to augment the normal healing process under these circumstances. However, further studies are needed to investigate the potential role of PRP on bowel anastomosis healing, especially in clinical settings.
Core Tip: The positive effect of platelet rich plasma (PRP) in bowel anastomoses has been shown by several studies. The application of PRP in bowel anastomoses in the presence of impaired wound healing conditions like ischemia, infection or chemotherapy significantly improved anastomosis burst pressure and tissue hydroxyproline, two of the most common used parameters to test anastomosis integrity. The current literature supports the effectiveness of PRP in animal models. Further studies are needed in order to determine the potential role of PRP in clinical practice.