Endorectal pull-through procedure for Hirschsprung's disease with and without primary anastomosis

The advantages of the endorectal pull-through procedure with primary anastomosis are: (1.) The absence of any pelvic dissection; (2.) the presence of normal propulsive colon right down to the anus; (3.) the preservation of the rectal muscular cuff and its sensory receptors; (4.) few, if any, anastomotic problems; (5.) the preservation of all sphincters and (6.) simple postoperative care. Although more time and experience are required to evaluate the procedure, we believe that its relative ease of performance, inherent safety, and physiologic soundness may make it the operation of choice for Hirschsprung's disease.