Anorectal Anomalies: A Review of Surgeries Past

The complex history of the surgical treatment of imperforate anus and anorectal anomalies illustrates the challenges of correcting this congenital defect. Initial procedures were designed to secure a stable outlet for the fecal stream. Despite an awareness of perineal muscular anatomy, early attempts to correct this anomaly failed to appropriately use this musculature and most patients suffered from problems related to constipation, incontinence, or fecal soiling. More recent surgical approaches demonstrate an evolving appreciation of the muscles of continence. The work of these past surgical pioneers has enhanced our understanding of anorectal musculature and its importance in continence and defecation. Their innovative procedures improved the outcomes for this challenging congenital defect.