1st order
- Primary surgical interventions are mainly performed for secondary constipation such as colon carcinoma (colorectal cancer).
Surgical therapy for chronic constipation should be considered only after differential diagnosis and exhaustion of conventional therapy.
Procedure of choice
- Colonic resection (subtotal colectomy) – removal of the colon; prior to this, to test the effect, it may be considered to create an ileostomy (artificial intestinal outlet at the level of the scrotum).
- In children, antegrade lavage (irrigation) is often inserted via an appendix/coecostomy (artificial intestinal outlet at the level of the appendix).
- Definitive (permanent) ileostomy may be used for severe chronic refractory slow transit constipation.
