PHẪU THUẬT CẮT MỘT PHẦN CƠ MU TRỰC TRÀNG HAI BÊN ĐỂ ĐIỀU TRỊ LOẠN HIỆP ĐỒNG CƠ SÀN CHẬU: BÁO CÁO 04 TRƯỜNG HỢP VÀ TỔNG QUAN TÀI LIỆU

Abstract

Introduction: Treatment of anismus usually starts with biofeedback therapy and injection of botulinum toxin in the puborectalis muscle (PRM). Patients refractory to conservative treatment may require surgery. Objective: The present report aimed to assess a technique of partial division of PRM in both sides for treatment of anismus. Methods: A retrospective study was conducted at the Anus – Rectum Department of the University of Medicine and Pharmacy Hospital in Ho Chi Minh City from 10/2020 to 10/2024, involving patients with anismus who failed conservative treatments were assessed clinically and with anal manometry, rectal sensation test, balloon expulsion test, MRI defecography, and underwent bilaterally partial division of PRM on both side. Main outcome measures were improvement in symptoms and patient satisfaction. Results: A total of 4 patients (2 males) of a mean age of 51.7 ± 15.1 years were included to the study. In total, 3/4 of patients showed a significant improvement in symptoms at 3 months postoperatively. The mean modified Altomare score decreased significantly (p=0.023) from 16.8 ± 3.1 to 7.5 ± 7.1 at 3 months postoperatively. The majority of patients (3/4) are very satisfied after surgery. There are not patients developed any complications. Conclusions: Partial division of puborectalis muscle is an effective technique in the management of anismus with satisfactory results and low incidence of complications. More cases with longer follow-up are needed to confirm its efficacy.