Surgical aspects of severe chronic non-Hirschsprung constipation.

This paper reviews the methods available for selecting patients with disabling non-Hirschsprung constipation eligible for surgery, and the surgical methods reported. It is concluded that careful evaluation of the patient may help in selecting the most suitable treatment. The demonstration, however, of a specific morphological abnormality would, of itself, not seem to justify surgical correction. The surgical criteria remain to be defined by additional physiological research, and the outcome of the various surgical procedures is always uncertain. Surgery should only be undertaken in patients with disabling symptoms, in whom prolonged conservative treatment has failed completely.