Objective:Severe functional constipation (SFC) was a challenging medical problem that might warrant surgery.This study compared stool frequency,postoperative complications and qualityoflife（QOL）outcomes of subtotal colectomy and combined use of subtotal colectomy and modified Duhamel procedure for SFC. Methods:Between June 2004 and July 2006,31 patients were randomized to receive subtotal colectomy (n=10) or combined surgery (n=21).The selection criteria were normal colonoscopy,abnormal colon transit time (CTT) and abnormal dynamic proctography (DPG).The functional outcomes after surgery were assessed by stool frequency and QOL outcomes over one year period. Results:The preoperative clinical manifestations of the two groups were similar.Functional outcomes with score costive gastrointestinal symptoms［(73.6±8.2)%vs(60.3±805)%］,GIQOL index score (107.6±8.2vs92.1±9.6),recurrent constipation rate(9.5% vs 60.0%) for combined use of subtotal colectomy and modified Duhamel procedure were significantly better than that for subtotal colectomy.No statistically significant difference was observed between the two groups for time for recovery of the bowel function,average length of postoperative hospitalization,and the early postoperative complications. Conclusion:Combined use of subtotal colectomy and modified Duhamel procedure for SFC was better GIQOL outcomes.