Surgical treatment of severe idiopathic chronic constipation [Il trattamento chirurgico della stipsi cronica idiopatica severa]

Based on their personal experience of 12 patients suffering from severe idiopathic chronic constipation, the Authors underline the indications and the type of surgical approach used. Surgery took the form of total colectomy using termino-terminal ileorectal anastomosis, whereas bilateral resection of the puborectal muscle was reserved for those patients with a marked releasc of the said muscle as shown by defecography. In conclusion, the Authors affirm that surgical treatment of constipation is indicated in severe cases with marked resistance to medical and dietary therapy over a long period of time. On the basis of the results obtained, the Authors consider total colectomy with termino-terminal ileorectal anastomosis as the optimal technique, whereas no definitive conclusions are drawn with regard to the bilateral resection of the muscle given the smal number of cases in which this operation was performed.