title: Elective laparoscopic sigmoid resection for diverticular disease has fewer complications than conventional surgery: a meta-analysis.
abstract: BACKGROUND
  We performed a meta-analysis of published literature comparing the complications after open and laparoscopic elective sigmoidectomy for diverticular disease.
  
  
  METHODS
  Electronic databases were searched from January 1991 to March 2009. A systematic review was performed to obtain a summative outcome.
  
  
  RESULTS
  Nineteen comparative studies involving 2,383 patients were analyzed. There were 1,014 patients in the laparoscopic group and 1,369 patients in the open group. There was no significant heterogeneity among any of the complications analyzed. Patients in the laparoscopic sigmoid resection group had fewer wound infections (fixed effects model: risk ratio [RR], .54; 95% confidence interval [CI], .36-.80; z, -3.05; P < .01; random effects model: RR, .59; 95% CI, .39-.89; z, -2.54; P < .05), blood transfusions (fixed effects model: RR, .25; 95% CI, .10-.60; z, -3.10; P < .01; random effects model: RR, .28; 95% CI, .11-.68; z, -2.81; P < .01), and ileus rates (fixed effects model: RR, .37; 95% CI, .20-.66; z, -3.34; P = .001; random effects model: RR, .37; 95% CI, .20-.68; z, -3.21; P = .001) compared with open sigmoid resections. No difference was seen for medical complications, need for rehospitalization, and reoperation.
  
  
  CONCLUSIONS
  Laparoscopic sigmoid resection is safe and has fewer postoperative surgical complications. This approach should be considered for elective cases, however, more randomized controlled trials are required to strengthen the evidence.
authors.affiliation: Department of Colorectal Surgery, Worthing Hospital, Worthing, West Sussex, United Kingdom. md0u812a@mac.com
authors.forename: Muhammad Rafay Sameem
authors.initials: MR
authors.lastname: Siddiqui
authors.forename: M S
authors.initials: MS
authors.lastname: Sajid
authors.forename: S
authors.initials: S
authors.lastname: Qureshi
authors.forename: E
authors.initials: E
authors.lastname: Cheek
authors.forename: M K
authors.initials: MK
authors.lastname: Baig
mesh_terms: D003082:Colectomy / Q000009:adverse effects* / Q000379:methods; D004241:Diverticulum, Colon / Q000601:surgery*; D017558:Elective Surgical Procedures / Q000009:adverse effects; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D012810:Sigmoid Diseases / Q000601:surgery*