Surgical repair involves creating an opening for passage of stool. Complete absence of an anal opening requires emergency surgery for a newborn.
All surgical repairs are done while the infant is deep asleep and pain-free (using general anesthesia).
Surgery for a high-type imperforate anus defect usually involves creation of a temporary opening of the large intestine (colon) onto the abdomen to allow passage of stool (this is called a colostomy). The baby is allowed to grow for several months before attempting a more complex anal repair.
The anal repair involves an abdominal incision, through which the colon is loosened from its attachments in the abdomen.
Through an anal incision, the rectal pouch is pulled down into place, and the anal opening is completed. The colostomy may be closed during this stage or may be left in place for a few more months and closed at a later stage.
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