[Anoplasty for anorectal anomalies in children]

The work analyses the causes of insufficient air-tightness of the anal canal in the postoperative period (in children operated on for anorectal developmental anomalies), which leads to anal incontinence. The authors suggest a method for anoplasty based on: (1) performance of sphincteroplasty with consideration for the function of three muscles forming the external sphincter of the anal canal; (2) formation from the musculo-serous coat of the intestine subjected to the pull-through procedure a soft elastic pad lining the canal on the inside; (3) creating conditions for adherence of the mucous coat of the intestine to the walls of the neoanal canal. Manometric, CT, and ultrasonic special methods of examination showed that with the use of the suggested method the obturative pressure in the neoanal canal increases, "prolapse" of the mucosa of the operated on intestine is prevented, the accumulative and evacuative functions of the rectum are improved. The causes and errors which led to poor results (2 cases) are analysed. In the remaining 42 cases the results were good and satisfactory.