Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Nov;31(11):1799-1804.
doi: 10.1007/s00384-016-2648-9. Epub 2016 Sep 26.

Phantom rectal sensations following abdominoperineal excision of the rectum (APER) and vertical rectus abdominis myocutaneous (VRAM) flap perineal reconstruction

Charlotte R Gould  1 , Graham Branagan  2
Affiliations

Phantom rectal sensations following abdominoperineal excision of the rectum (APER) and vertical rectus abdominis myocutaneous (VRAM) flap perineal reconstruction

Charlotte R Gould et al. Int J Colorectal Dis. 2016 Nov.

Abstract

Aim: Phantom rectum is the sensation of an intact and/or functioning rectum, despite excision at surgery. Abdominoperineal excision of the rectum (APER) may be complemented by reconstructive operations and recently it was reported that patients undergoing APER and vertical rectus abdominis myocutaneous (VRAM) flap reconstruction are more prone to develop phantom sensations at an earlier timeframe and have more persistent symptoms than those who do not have perineal repairs. The aim of this study was to determine the prevalence of phantom rectal sensations in a cohort of these patients.

Method: Patients who underwent APER and VRAM flap reconstruction for anorectal carcinomas were identified from May 2008 to July 2012. Patients completed a questionnaire evaluating their experience of rectal symptoms post-surgery.

Results: Thirty-four of 47 eligible patients were enrolled in the study. PR sensations were experienced by 50 % of patients, the majority of which (65 %) were present for >1 year. The commonest sensation reported was the feeling of faeces in a normal rectum (24 %). Disturbances in quality of life were apparent in 44 %; notably, sleep was affected, patients expressed increased feelings of stress/sadness, heightened levels of anxiety and limitation of daily activities as consequences of PR symptoms. Few patients sought medical advice.

Conclusion: Fifty percent of patients experience PR sensations post-surgery, comparable with reported data for patients who have undergone APER alone. The addition of VRAM reconstruction does not significantly alter the prevalence of PR symptoms. This paper provides further evidence that phantom rectum occurs frequently and thus all patients undergoing excision of the rectum should be counselled appropriately.

Keywords: APER—abdominoperineal excision of the rectum; PR(S)—phantom rectal (sensations); PRP—phantom rectal pain; VRAM—vertical rectus abdominis myocutaneous.

PubMed Disclaimer

References

    1. J Wound Ostomy Continence Nurs. 2013 May-Jun;40(3):280-6 - PubMed
    1. Colorectal Dis. 2013;15(10):1309-12 - PubMed
    1. Lancet Neurol. 2002 Jul;1(3):182-9 - PubMed
    1. J Hist Neurosci. 2010 Oct;19(4):299-312 - PubMed
    1. Pain Res Treat. 2011;2011:864605 - PubMed

LinkOut - more resources