[Surgical therapy of severe chronic constipation].

Primary chronic constipation is an ailment of modern civilisation. Severe forms can seldom be treated satisfactorily by conservative methods, and in these cases surgical intervention must be considered. This consists of subtotal colectomy with ileosigmoidostomy. Partial resection and hemicolectomy do not afford the desired result. A report is presented on 28 patients who had subtotal colectomy for chronic constipation during the period 1959 to 1976. Immediate and long-term results have proved to be surprisingly good. Unsatisfactory conditions are to be expected in patients with strong complementary psychoneurotic symptoms. Preoperative investigations must be carried out with precision, morphological changes accurately identified and treated by differentiated surgical methods. The indication for colectomy in cases of chronic constipation must be strictly established, if possible in collaboration with a gastroenterologist.