Congenital anal atresia is in the embryo in the 4th to 8th week from the urogenital septum to the cloaca migration obstruction caused by a common digestive malformation, accounting for the first digestive malformation, the incidence rate of about 1/1500 ~ 1/5000, more men than women, male-to-female ratio is about 3:1, there is no racial difference, part of the case has a tendency of family morbidity; according to the domestic deformity monitoring network statistics, in our country’s incidence rate of 2.81/10000, the incidence rate is 2.81/10000, the incidence rate is 2.81/10000, and the incidence rate is 2.81/10000, and the incidence rate is 2.81/10000. million. The occurrence of anal atresia is the result of normal embryonic developmental disorders. The cause of anal atresia is unclear, and in recent years many authors have suggested that anal atresia is associated with genetic factors. The rectum is the terminal portion of the colon, which is attached to the sigmoid colon and passes through the pelvic floor at its lower end to join the anal canal. The internal anal sphincter consists of a thickening of the circular muscle of the lower end of the rectum, encircling 3/4 of the anus, and is crossed by fibers of the longitudinal rectum and the anal raphe. The internal sphincter is a smooth muscle, subject to autonomic innervation, has an involuntary control function on defecation, usually in a state of tension and contraction, to keep the anal canal closed. During defecation, the internal sphincter relaxes and the anal canal opens. The external anal sphincter is a casual muscle, around the anal canal is divided into three muscle ring, the top ring by the external sphincter deep and puborectalis muscle, starting from the pubic symphysis, distribution of the upper part of the anal canal at the rear and both sides; in the middle of the ring by the external sphincter, starting from the tip of the coccyx, divided into two halves around the anal canal on both sides and then forward joint; the bottom of the external sphincter dermatome composed of the skin, starting from the skin of the anus in front of the anus, around the anus on both sides, in the anus at the back of the joint. The three rings are innervated by the perineal and anal nerves. The external sphincter can control defecation, contraction of the top ring and the bottom ring pull down the posterior wall of the anal canal; the middle ring will pull the anal canal backward, resulting in the three ring contraction time in different directions to pull, thus strengthening the sphincter function, the formation of hinged closure of the anus, in order to counteract the role of the internal sphincter of the relaxation of the external sphincter when the external sphincter relaxation of fecal matter is discharged. The top and middle rings of the three rings are powerful and can cause incontinence when cut off. The anorectalis muscle is an important muscle of the pelvic floor, which has three parts, i.e., puborectalis, pubococcygeus and iliococcygeus, and is innervated by the sacral nerve and the anal nerve or or perineal nerve. If this disease is not treated early, it can affect the growth and development of the affected children, and even lead to death, therefore, early treatment is very important for this disease. Currently, there are many methods of treatment, and the surgical methods have various types of operation, such as: Stephens’ sacro-perineal anoplasty and Pena’s posterior sagittal approach anoplasty, Nicolai a Rehbein’s modified surgery, etc. Each has its own characteristics and different effects. 1980 deVire and Pen proposed to make a posterior sagittal incision by the sacro-coccygeal region in the middle of the sacrum and place the transversus muscle (including pubococcygeal nerve) into the anus to prevent the disease. In 1980, deVire and Pen proposed to make a posterior sagittal incision from the middle of the sacrococcygeal region to separate the muscle fibers of the transversus muscle complex (including the puborectalis muscle and external anal sphincter) from the middle of the rectum, and then place the rectum in the transversus muscle complex to form the anus, which not only makes use of the puborectalis muscle, but also makes full use of the external sphincter. In recent years, many scholars have found that rectal anus malformation, especially in the middle and high malformation in the distal rectum and fistula of the intestinal wall ring muscle limited thickening, that is, there is an internal sphincter or internal sphincter prototype, therefore, emphasize that in the anorectal plasty should be preserved and use the internal sphincter as much as possible. As people’s living standards improve, the surgical requirements for children and their immediate complications and quality of life in the long term are also higher.