title: Laparoscopic versus open sigmoid resection for diverticulitis: long-term results of a prospective, randomized trial.
abstract: BACKGROUND
  Elective laparoscopic sigmoid resection for diverticulitis has proven short-term benefits, but little data are available from prospective randomized trials regarding long-term outcome, quality of life, and functional results.
  
  
  METHODS
  Of 113 patients randomized to undergo laparoscopic (LAP) versus open (OP) sigmoid resection for diverticulitis, 105 (93%, LAP = 54, OP = 51) patients were examined and answered the Gastrointestinal Quality of Life Index (GIQLI) questionnaire, with a median follow-up of 30 (range, 9-63) months after surgery.
  
  
  RESULTS
  Incisional hernias were detected in five (9.8%) patients in the OP group versus seven (12.9%) in the LAP group, P = 0.84). Overall satisfaction with the operation on a scale of 0 (very poor) to 10 (excellent) was 9 (range, 2-10) in the OP group versus 9 (range, 2-10) in the LAP group (P = 0.78). Median GIQLI score was 115 (range, 57-144) in the OP group versus 110 (range, 61-134) in the LAP group (P = 0.17). Overall satisfaction with the cosmetic aspect of the scar on a scale of 0 (very poor) to 10 (excellent) was 8 (range, 1-10) in the OP group versus 9 (range, 0-10) in the LAP group (P = 0.01). Finally, median hospital cost (including reoperations for hernias) was 11,606 (5,230-147,982) CHF in the LAP group versus 12,138 (6,098-39,786) CHF in the OP group (P = 0.47).
  
  
  CONCLUSIONS
  Both open and laparoscopic approaches for sigmoid resection achieve good long-term results in terms of gastrointestinal function, quality of life, and patients' satisfaction. Significant long-term benefits of laparoscopic surgery are restricted to cosmetic (ClinicalTrials.gov protocol #NCT00453830).
authors.affiliation: Department 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: Béatrice
authors.initials: B
authors.lastname: Mugnier-Konrad
authors.forename: Philippe
authors.initials: P
authors.lastname: Morel
authors.forename: Olivier
authors.initials: O
authors.lastname: Huber
authors.forename: Ihsan
authors.initials: I
authors.lastname: Inan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D012809:Colon, Sigmoid / Q000601:surgery*; D004238:Diverticulitis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D011788:Quality of Life; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D016896:Treatment Outcome