目的　报道既不用开腹 ,也不需腹腔镜 ,在微创的情况下实现对小儿先天性巨结肠症的根治术式。方法　采用经肛门斜行切断直肠 (前高后低 ) ,处理直肠、结肠系膜 ,拖出病变肠管并予以切除 ,结、直肠I期斜面吻合的方法 ,治疗短段型 (5例 )及普通型 (18例 )巨结肠共 2 3例。结果　全部患者手术获得成功 ,术后无须扩肛 ,随访 1～ 12个月 ,排便正常 ,未出现不良并发症。结论　非开腹式 ,经肛门拖出并切除病变结肠 ,是一种全新的手术路径。它在实现对巨结肠根治的同时 ,获得了最佳的美容效果 ,并降低了一定的术后并发症。 The purpose of reporting neither laparotomy nor laparoscopy, minimally invasive treatment of children with Hirschsprody’s radical surgery. Methods The rectum (anteroposteriorly high and low) was transanal antegrade, the rectum and the mesocolon were treated, the diseased bowel was excised and resected. The anastomosis of stage I and rectum I was performed to treat the short segment (5 cases) and common type (18 cases) Hirschsprung a total of 23 cases. Results All patients were successful in operation. There was no postoperative anal augmentation. The patients were followed up for 1 to 12 months and had normal defecation without any adverse complications. Conclusion Non-laparotomy, traumatic anus and removal of diseased colon are a new surgical approach. It is in the realization of the radical colon at the same time, get the best cosmetic results, and reduce some of the complications after surgery.