title: Sigmoid resection for diverticulitis is more difficult than for malignancies.
abstract: OBJECTIVE
  Sigmoid resection for diverticulitis is usually the first procedure performed when starting the learning process for laparoscopic colorectal surgery. The aim of this study is to evaluate the difficulty of laparoscopic sigmoid resection for diverticulitis in comparison to sigmoid malignancy in order to assess its role in the residents training program.
  
  
  METHODS
  A cohort of patients was selected who suffered either from malignancy or recurrent diverticulitis in the sigmoid colon. Laparoscopic sigmoid resection was performed. The degree of difficulty was assessed by intraoperative complications and intraoperative technical challenges. Furthermore, take-overs from assistant to surgeon, surgeon to surgeon, and conversion were reported.
  
  
  RESULTS
  A total of 224 patients were included, 119 (53.1%) men and 105 (46.9%) women. Patients suffering from diverticulitis had significantly less co-morbidities than those with malignancies. In the diverticulitis group, there were significantly more technical challenges. There was a higher rate in take-overs from residents (p = 0.02) as well as surgeon to surgeon (p = 0.04). The rate of conversions was also significantly higher in the diverticulitis group (p = 0.03) when compared to the malignancy group.
  
  
  CONCLUSIONS
  The outcomes of our study show that diverticulitis may not be the ideal condition to start the learning process for laparoscopic colorectal surgery.
authors.affiliation: Department of surgery, Meander Medical Centre, PO box 1502, 3800 BM, Amersfoort, the Netherlands. mawstam@hotmail.com.
authors.forename: Maw
authors.initials: M
authors.lastname: Stam
authors.affiliation: Department of surgery, Meander Medical Centre, PO box 1502, 3800 BM, Amersfoort, the Netherlands.
authors.forename: W A
authors.initials: WA
authors.lastname: Draaisma
authors.affiliation: Department of surgery, Meander Medical Centre, PO box 1502, 3800 BM, Amersfoort, the Netherlands.
authors.forename: Pcm
authors.initials: P
authors.lastname: Pasker
authors.affiliation: Department of surgery, Meander Medical Centre, PO box 1502, 3800 BM, Amersfoort, the Netherlands.
authors.forename: Ecj
authors.initials: E
authors.lastname: Consten
authors.affiliation: Department of surgery, Meander Medical Centre, PO box 1502, 3800 BM, Amersfoort, the Netherlands.
authors.forename: Iamj
authors.initials: I
authors.lastname: Broeders
mesh_terms: D000368:Aged; D012809:Colon, Sigmoid / Q000601:surgery*; D015897:Comorbidity; D004239:Diverticulitis, Colonic / Q000601:surgery*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D012811:Sigmoid Neoplasms / Q000601:surgery*
keywords: Diverticulitis; Diverticulitis recurrences; Learning curve; Sigmoid resection; Surgery