Prospective evaluation of the quality of laparoscopic sigmoid resection for diverticular disease.
OBJECTIVE
There were no studies comparing whether the same principles as those in conventional surgery have been applied to the laparoscopic procedure. The aim of this study was to compare the quality of open sigmoid colectomy (OSC) with laparoscopic sigmoid colectomy (LSC) for diverticular disease. Specific measurements made were of the level of anastomosis from sacral promontory, distance from anal verge, specimen length and recurrence rates.


METHODS
Comparison was made between 72 consecutive patients who underwent an elective LSC to a control group of 22 patients who had previously undergone an OSC in the same institution. All patients had proctoscopy to measure the distance from the anal verge. A computed tomography without injection of contrast medium was performed in all cases to measure the distance from the sacral promontory to the top of the staple row. Length of fresh resected specimen and recurrence rates of diverticulitis were used for comparison.


RESULTS
There was no statistical difference between the two groups in terms of distance of anastomosis from anal verge (p=0.78) and distance from sacral promontory (p=0.65) in LSC and OSC patients respectively. Specimen length was more extensive in the OSC group than in the LSC group (p=0.02). After a mean follow-up of 43.5 (+/- 14.8) months in the LSC group and 62.4 (+/- 7.4) months in the OSC group, there was no difference in recurrent attack's rates of diverticulitis.


CONCLUSIONS
This study suggested that laparoscopic procedure applied the same principles as those used in conventional surgery.
Regenet
Nicolas
N
Department of Digestive Surgery, CHU Angers, Angers, France. nicoregenet@yahoo.fr
Pessaux
Patrick
P
Tuech
Jean-Jacques
JJ
Hennekinne
Stephanie
S
Lermite
Emilie
E
Ridereau-Zins
Catherine
C
Aube
Christophe
C
Bergamaschi
Roberto
R
Jean-Pierre
Arnaud
A
D000368:Aged; D003082:Colectomy / Q000379:methods*; D004239:Diverticulitis, Colonic / Q000601:surgery; D043963:Diverticulosis, Colonic / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D012810:Sigmoid Diseases / Q000601:surgery*; D016896:Treatment Outcome