BACKGROUND: Patients with chronic constipation can be difficult to manage either medically or surgically. We used Roma classification as criteria for including patients in our study. There are many diseases which could lead to chronic constipation. If they are treated by a surgeon, there can be obtained a permanent therapeutic effect. The group of patients with idiopathic chronic constipation couldn't obtain satisfying effect by surgical treatment, which was presided by inaccurate and embarrassed selection. Our aim is to present the results of experience of Clinic of General and Operative Surgery, Varna, Bulgaria.
MATERIAL: For a period of 10 years, we have been operated 52 patients with diagnosis as morbus Pair (15 patients), megacolon (31 patients), and idiopathic chronic constipation (6 patients). The main indication for undergoing surgical treatment was the retention of more then 20% of the applied barium enema after the 5th day from irrigography. There were applied the followed operative methods: colectomy, subtotal colectomy, hemicolectomy, resection of the colon sygmoideum, anterior resection of the rectum and mobilization of the lineal flexure. We did analysis of the results. The evaluation of curativeness to applied methods was done. We followed the quality of life of our patients from 11 months to 6.2 years (median 3.2 years).
CONCLUSION: The presence of organic disease is associated with very good therapeutic effect from the surgical treatment of chronic constipation. The problem with idiopathic chronic constipation remains unsolved when colectomy with ileo-recto anastomosis was undergone. The right selection of patients is a crucial factor for the success of the surgical treatment.
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