 The investigators study aims to compare the results of percutaneous endoscopic caecostomie CPE to optimal medical therapy in the treatment of patients with constipation refractory to medical treatment. The primary endpoint will be the quality of life assessed by the Gastrointestinal Quality Of Life Index GIQLI at one year. The secondary endpoints are digestive symptoms, Kesss constipation scores and Clevelands incontinence score, tolerance of the Chait TrapdoorTM caecostomy catheter CTCC and the collection of possible complications. The patients included must meet the classification criteria of Rome III, have an elongated colonic transit time, have had a complete colonoscopy and be refractory to medical treatment including at least one stimulant laxative or suppositories or enemas retrograde. 