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Abstract
An incisional approach to the posterior perineum and inferior pelvis through a lateral
buttock-reflecting incision has been described. This approach has been used in the
surgical management of 7 patients with imperforate anus abnormalities. Attention has
been directed toward the normal anatomy of the anorectum and the importance of restoring
these normal relationships insofar as possible. In those cases in which the rectum
ends above the levator muscles, it should be brought through the pelvic floor immediately
behind the bladder and prostate in the male or the vagina in the female, so as to
be in the grasp of the puborectalis sling. It is then directed posteriorly and inferiorly
into the grasp of the circular deep and superficial external sphincter muscles. It
is further desirable to construct a deep skin-lined anal canal to the level of the
deep external sphincter so as to prevent mucosal eversion with its constant mucoid
discharge.
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References
- Continence after surgery for imperforate anus: A critical analysis and preliminary experience with sacroperineal pull-through.Ann. Surg. 1963; 158: 498
- The external sphincter in cases of imperforate anus: A pathologic study.Surgery. 1961; 49: 807
- Congenital imperforate rectum, rectourethral and rectovaginal fistulae.Australia & New Zealand J. Surg. 1953; 22: 161
- Imperforate rectum: A new surgical technique.M. J. Australia. 1953; 2: 202
- Imperforate anus.M. J. Australia. 1959; 2: 803
Article info
Publication history
Received:
May 25,
1964
Footnotes
☆Presented before the Surgical Section of the American Academy of Pediatrics, Oct. 5, 1963.
Identification
Copyright
© 1965 Published by Elsevier Inc.
