Open surgical therapy for constipation

This paper reviews diagnostic criteria, indications, and selection criteria for surgical therapy in chronic constipation. Special emphasis is laid on surgical therapy of pelvic outlet obstruction. Colonic resection may be con sidered as last surgical resort in those few cases where conventional thera peutic measures have been exhausted and an extensive diagnostic protocol ba sed on clearly defined criteria has been followed. This may offer a justifi able therapeutic alternative only in cases where highly symptomatic and ref ractory colonic inertia (slow transait constipation) is confirmed, and asso ciated outlet obstruction has been excluded.