原位转流术在直肠癌根治术后的临床效果以及对吻合口愈合、患者疼痛程度、生活质量的影响

In-Situ Diversion Technique’s Clinical Efficacy after Radical Resection of Rectal Cancer and Its Effects on Anastomotic Healing, Patient Pain Levels, and Quality of Life

摘要: 目的：探析原位转流术在直肠癌根治术(Abdominoperineal Resection, APR)后的临床效果以及对吻合口愈合、患者疼痛程度、并发症发生率、生活质量的影响。方法：研究在钦州市第二人民医院中选取直肠癌根治术治疗患者60例，时间范围2023年1月~2025年5月，利用随机数字表法分成2组，每组例数30例，对照组：予以常规吻合口处理，观察组：实施原位转流术，比较组间的吻合口愈合率、术后并发症发生率以及患者的生活质量评价分数。结果：随访调查两组APR患者术后2周吻合口愈合情况，观察组吻合口愈合率为90.00%，对照组为73.33%，P > 0.05；直肠癌术后观察组并发症率(10.00%)低于对照组，P > 0.05；观察组术后平均吻合口愈合时间、术后首次排气、排便、胃肠功能恢复时间、住院时间更短，P < 0.01；观察组术后患者生活质量QL-Index评分更高，P < 0.05；观察组术后第1天至术后第14天的疼痛程度均低于对照组，疼痛消失时间大约在2天，指标比较P < 0.01。结论：在直肠癌根治术(APR)中加入原位转流技术可以有效降低术后吻合口瘘、出血和狭窄等风险，减轻患者术后的疼痛程度，缩短术后康复周期，优化患者的生活质量。

Abstract: Objective: To analyze the clinical efficacy of in-situ diversion technique following abdominoperineal resection (APR) for rectal cancer, and its impact on anastomotic healing, pain levels, complication rates, and quality of life. Methods: This study enrolled 60 patients undergoing APR at the Second People’s Hospital of Qinzhou from January 2023 to May 2025. Participants were randomly divided into two groups (n = 30 each) using a random number table. The control group received conventional anastomosis management, while the observation group underwent in-situ diversion. Comparative analyses included anastomotic healing rates, postoperative complication incidence, and quality of life assessment scores. Results: A follow-up survey was conducted on the anastomotic healing status of APR patients in both groups at 2 weeks postoperatively. The anastomotic healing rate was 90.00% in the observation group and 73.33% in the control group (P > 0.05). The complication rate after rectal cancer surgery was lower in the observation group (10.00%) compared to the control group (P > 0.05). The observation group showed significantly shorter average anastomotic healing time, first postoperative flatus, defecation, gastrointestinal function recovery time, and hospital stay (P < 0.01). Quality of Life Index (QL-Index) scores were significantly better in the observation group (P < 0.05). From postoperative day 1 to day 14, the observation group exhibited consistently lower pain levels with approximately 2-day earlier pain resolution (all P < 0.01). Conclusion: Incorporating in situ diversion techniques during APR for rectal cancer effectively reduces risks of anastomotic leakage/stricture, alleviates postoperative pain, accelerates recovery, and optimizes patients’ quality of life.