الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
BACK GROUND :
Consists of 23 pages and entails the definition of constipation in general and chronic idiopathic constipation and its types in particular .
Also the causes of constipation and the investigations which can be done for patients suffering from chronic idiopathic constipation in details .
Also it contains and account on two chronic idiopathic constipation scoring systems which are used in assessment of the constipation status of the patients pre and post operative .
It also contains the methods of treatment of constipation either conventional or surgical .
OBJECTIVES :
Consists of one page and contains that the aim of this work is to assess the efficacy of anorectal myectomy as a surgical treatment for cases of chronic idiopathic constipation.
METHODS :
Consists of 8 pages and contains that this study conducted on 20 patients suffering from chronic idiopathic constipation selected from patients with chronic constipation presenting to the colorectal surgery unit in the main University Hospital, Faculty of Medicine, Alexandria University, after doing the following :
(I) Clinical assessment :
a) Complete history taking .
b) Thorough Physical examination :
• General examination .
• General psychological assessment of the patient.
• Examination of the mouth .
• Abdominal examination .
• Rectal examination .
(II) Investigations :
a) Laboratory .
b) Radiological : barium enema .
Then the patients proved to have chronic idiopathic constipation are then subjected to the following :
1) Pre-operative scoring of their constipation status :
Using the constipation scoring systems :
The first reported by D. Altomare et al., 1996 .
The second reported by Agachan et al., 1996 .
2). Rectal sensation study .
3) Colon transit time (C.T.T) study .
4) Anorectal myectomy .
5) Post operative rescorig of constipation status after one month :
This rescoring is done using the two constipation scoring system to assess the efficacy of anorectal myectomy as a surgical treatment for chronic idiopathic constipation which may be improved or not , and then the patient will be subject to another type of surgery.
RESULTS :
Consists of 26 pages and contains that :
• As regard the colon transit time study there were 75% of the patients suffering from delayed colon transit time ( colonic inertia ) , and 25% of the patients suffering from functional outlet obstruction .
• As regard rectal sensation study there was decrease in the all three elements of rectal sensation for most of the patients .
• As regard the hiastopathological examination of anorectal myectomy biopsies there was ganglionosis in 10% of the specimens and aganglionosis in 90% of the specimens .
• As regard the use of constipation scoring systems pre and post operative there was improvement of almost all the variables of constipation scoring systems in 65% of the patients after the operation .