Abstract
Faecal control of the newly formed anus is the chief objective in the repair of ano-rectal anomalies. The immediate relief of obstruction in the newborn period may be achieved by colostomy (with secondary rectoplasty later), or by primary rectal reconstruction, but in the long term the functional result of continence is the final arbiter of the choice of treatment. Continence may be discussed in three phases : A. The pre-operative assessment of the level of the deformity in relation to the available sphincters. B. The operative procedures which best preserve the sphincters. C. The post-operative factors which secondarily interfere with control.
