Role of subtotal colectomy in the treatment of incapacitating constipation.

Nine patients from a community surgical practice have been presented who underwent subtotal colectomy with ileal lower sigmoid anastomosis for the treatment of chronic incapacitating idiopathic constipation. Emphasis was placed on carefully selecting patients for this procedure. The results in this small series have been promising. Long-term follow-up is necessary to determine whether the patients will continue to do well. A review of the literature regarding the surgical treatment of constipation has indicated that subtotal colectomy is the most successful form of treatment in select patients. More studies are needed, specifically in the area of radiopaque markers and anorectal manometry, to determine whether or to what extent these procedures can help select patients who might benefit from this procedure.