High anorectal atresia - surgical treatment through a sacro-coccygeal-perineal approach.

10 infants with high anorectal atresia had a primary colostomy and later a definitive pull-through operation was performed. This was accomplished through a sacro-coccygeal approach and enabled easy and precise identification of the pubo-rectalis sling of the levator ani muscle. Placement of the rectum inside this sling is the most important factor in achieving post-operative faecal continence in these infants. A follow-up period of 4--10 years showed good bowel control in 9 patients, although occasional slight soiling occurs.