title: A prospective, randomized, single-blind comparison of laparoscopic versus open sigmoid colectomy for diverticulitis.
abstract: OBJECTIVE
  The aim of this study was to compare open and laparoscopic sigmoid resection for diverticulitis with the patient and the nursing staff blinded to the surgical approach.
  
  
  METHODS
  A total of 113 patients scheduled for an elective sigmoidectomy were randomized to receive either a conventional open (54 patients) or a laparoscopic (59 patients) approach. Postoperatively, an opaque wound dressing was applied and left in place for 4 days, and patients from both groups were managed similarly. The primary endpoints for analysis were (1) postoperative pain; (2) duration of postoperative ileus; and (3) duration of hospital stay (ClinicalTrials.gov, number NCT 00453830).
  
  
  RESULTS
  The median duration of procedure was 165 minutes (range, 90-285) in the laparoscopy group and 110 minutes (range, 70-210) in the open group (P < 0.0001). The median delay between surgery and first bowel movement was 76 (range, 31-163) hours in the laparoscopy group versus 105 (range, 53-175) hours in the open group (P < 0.0001). The median score for maximal pain (assessed by a visual analog scale) was 4 (range, 1-10) in the laparoscopy group and 5 (range, 1-10) in the open group (P = 0.05). Finally, the median duration of hospital stay was 5 days (range, 4-69) in the laparoscopy group versus 7 days (range, 5-17) in the open group (P < 0.0001).
  
  
  CONCLUSIONS
  Laparoscopic sigmoid resection is associated with a 30% reduction in duration of postoperative ileus and hospital stay; by comparison, benefits in terms of postoperative pain appear less impressive, when the patient is blinded to the surgical technique.
authors.affiliation: Departments of Surgery, Geneva University Hospital and Medical School, Geneva, Switzerland. pascal.gervaz@hcuge.ch
authors.forename: Pascal
authors.initials: P
authors.lastname: Gervaz
authors.forename: Ihsan
authors.initials: I
authors.lastname: Inan
authors.forename: Thomas
authors.initials: T
authors.lastname: Perneger
authors.forename: Eduardo
authors.initials: E
authors.lastname: Schiffer
authors.forename: Philippe
authors.initials: P
authors.lastname: Morel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy / Q000379:methods*; D012809:Colon, Sigmoid / Q000601:surgery*; D043963:Diverticulosis, Colonic / Q000601:surgery*; D006801:Humans; D045823:Ileus / Q000209:etiology; D010535:Laparoscopy; D007902:Length of Stay; D008875:Middle Aged; D019547:Neck Pain / Q000503:physiopathology; D011183:Postoperative Complications; D011446:Prospective Studies; D012810:Sigmoid Diseases / Q000601:surgery*