Anorectal reconstruction--restoring continence after abdominoperineal excision of the anorectum

This article describes the technique of anal sphincter reconstruction using electrically stimulated graciloplasty. The results of recent published series of reconstruction after abdominoperineal excision are analyzed, and the modifications used to reduce complications are explored. Techniques of rectal reconstruction and methods of improving evacuation are also discussed. Techniques of reconstruction after high anorectal atresia as well as possible future developments in this field are considered. In the final section the possible qualitative benefits and the health economics of anorectal reconstruction are examined.