[Assessment and achievement of postoperative continence in imperforate anus]

Functional results after surgical correction of anorectal malformations were assessed on a clinical basis following Kelly score, by manometric and radiologic studies. Sixty-five patients, older than 5 years, were personally interviewed and 51 of the 65 had manometric and radiologic studies to evaluate postoperative continence. Continent patients with high type lesions as well as those with low type lesions characteristically had a marked anorectal pressure difference and an acute anorectal angulation in the defecogram. On the other hand, in the patients with fair or poor results, neither a marked anorectal pressure difference nor anorectal angulation was found. These results indicate that achievement of continence in patients with a high type lesion treated by staged abdominoperineal rectoplasty depends upon bringing the terminal bowel down exactly within the sling of the puborectalis muscle.