title: [Postoperative anal prolapse in patients with anorectal malformations: 16 years of experience].
abstract: BACKGROUND
  Anal prolapse is a common postoperative complication related to anorectal malformations (MAR) surgery, which is sometimes considered to be insignificant and/or not worthy of further intervention. We analysed the causes of this complication and our current surgical protocols.
  
  
  METHODS
  Since 1995, 26 patients with anal prolapse have been operated secondary to surgical correction of an anorectal pathology. The most common MAR in girls (12) was cloaca (10), and in boys (14) was anorectal atresia with prostate fistula (8). The symptoms were anal pain and bleeding associated with alterations in bowel control alterations. The diagnosis in most patients was made in the first months after surgery, during the period of anal dilatations period. The surgical procedure involves prolapse resection of the prolapse and a new anoplasty. In 18 patients (69%) the prolapse was corrected before the colostomy closure on an outpatient basis. The other 8 patients (31%) underwent prolapse surgery after colostomy closure, requiring hospitalisation.
  
  
  RESULTS
  There were no immediate postoperative complications, improving continence and aesthetic anus appearance. In 4 patients the prolapse recurred, requiring further surgical correction.
  
  
  CONCLUSIONS
  Anal prolapse is a possible minor complication after anorectal correction. MAR type, the quality of the perineal musculature and defects in surgical technique are the main factors determining ia prolapse will appearance. The anal prolapse surgery indication has been recently increased (including small unilateral prolapses) as long as they are done before the colostomy closure, due to good aesthetic and functional results, requiring only outpatient surgery.
authors.affiliation: Servicio de Cirugía Pediatrica, Hospital Infantil Gregorio Marañón, Madrid. mariazornoza@gmail.com
authors.forename: M
authors.initials: M
authors.lastname: Zornoza
authors.forename: E
authors.initials: E
authors.lastname: Molina
authors.forename: J
authors.initials: J
authors.lastname: Cerdá
authors.forename: M
authors.initials: M
authors.lastname: Fanjul
authors.forename: C
authors.initials: C
authors.lastname: Corona
authors.forename: A R
authors.initials: AR
authors.lastname: Tardáguila
authors.forename: R
authors.initials: R
authors.lastname: Rojo
authors.forename: A
authors.initials: A
authors.lastname: Cañizo
authors.forename: M A
authors.initials: MA
authors.lastname: García-Casillas
authors.forename: D
authors.initials: D
authors.lastname: Peláez
mesh_terms: D001003:Anal Canal / Q000002:abnormalities*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D012005:Rectal Prolapse / Q000209:etiology*; D012007:Rectum / Q000002:abnormalities*; D013997:Time Factors