Morbidity of Rectal Prolapse Repair After Surgery for Anorectal Malformation
Topic overview
Retrospective study of 85 patients with repaired anorectal malformations who underwent rectal prolapse repair found 31% recurrence and 32% developed postoperative stricture. Asymptomatic patients had significantly higher stricture rates (41% vs 16%), suggesting expectant management may be preferable for asymptomatic prolapse.
Key takeaways
- Rectal prolapse after ARM repair has 31% recurrence rate and 32% stricture rate, requiring close long-term follow-up.
- Asymptomatic prolapse patients have 2.5x higher stricture risk (41% vs 16%) and should be managed expectantly, not surgically.
- Simultaneous ostomy takedown with prolapse repair significantly increases recurrence risk and should be avoided when possible.
- Post-operative stricture occurs in nearly one-third of patients, with most requiring Heineke-Mikulicz stricturoplasty for management.
- Extent of prolapse repair (partial vs circumferential) does not affect recurrence or stricture rates in this cohort.
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