There are many surgical methods used at home and abroad, but the ultimate goal is to reconstruct the anorectum and restore the patency of the intestinal tract while correcting perineal anorectal deformities. 1. Disposable posterior anal incision and shaping: Children with a clear diagnosis of low anal atresia, especially males, can be judged with the aid of neuromuscular stimulator to determine the position of the external anal dilator muscle, while posterior anal incision and shaping is simple, with short operation time and fast postoperative recovery, usually without sequelae and complications. 2, Phase I colostomy: Male children diagnosed with moderate to high anal atresia, especially those with a clear diagnosis of rectourethral fistula or other abnormally complex fistulas should adopt a staged surgical approach, Phase I of the descending colonic double-hole fistula enterostomy location should be carefully selected, the location should not be too low to avoid surgical difficulties caused by too much tension in the downward migration of the rectum during Phase II anal molding, it is recommended that Phase II fistulas be performed months after fistulotomy The second-stage fistula repair and anoplasty at the same time is recommended. 3. second-stage fistula repair + anal reconstruction (pena surgery): for male infants with complex anal atresia and definite rectourethral fistula with a high blind end position and for female infants with special types of abnormal fistulae, but mainly for male infants the main elements of pena surgery are: rectourethral fistula downward displacement of the blind end of the rectum, dorsal rectal narrowing and reconstruction of the pelvic floor musculature because the occurrence of rectourethral fistula in female infants is rare. Since rectourethral fistulas are rare in female infants, the pena procedure refers specifically to urethra-related anal reconstruction in male infants. The technical details of the operation are directly related to the postoperative anal appearance and defecation function. 4. Posterior sagittal anoplasty (caudal anoplasty): usually used for infants with high blind end and complex fistulas, especially for infants with a history of unsuccessful surgery resulting in rectal retraction, and more often for female infants because the fistulae of female infants are not related to the urethra, so caudal anoplasty is relatively simple compared to pena. 5. Perineal anoplasty: Most of the low anal atresia is associated with abnormal fistula or fistula tracts manifesting as ectopic defecation, and in such patients and patients with anterior displacement of the anus, perineal anoplasty is indicated. 6. Combined perineal anoplasty: The blind end of the rectum is located above the peritoneal reflexion in special patients who are unable to complete the lower rectal migration through the perineum, if necessary, open surgery is needed to loosen the auxiliary surgery is complex, the operation takes a long time and the operation is a big blow. 7, combined abdominal sacral anoplasty: the operation can not be completed via the sacrococcygeal if necessary need to open the abdominal auxiliary surgery difficult.