[Open surgical therapy of 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 considered as last surgical resort in those few cases where conventional therapeutic measures have been exhausted and an extensive diagnostic protocol based on clearly defined criteria has been followed. This may offer a justifiable therapeutic alternative only in cases where highly symptomatic and refractory colonic inertia (slow transit constipation) is confirmed, and associated outlet obstruction has been excluded.