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).
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Disclosures
Pascal Gervaz and Ihsan Inan have been employed since 2008 as consultants and have received honoraria from Covidien (formerly Tyco Healthcare) for a total sum of 4,000 Euros each per year. Béatrice Mugnier-Konrad, Philippe Morel, and Olivier Huber have no conflicts of interest or financial ties to disclose.
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Gervaz, P., Mugnier-Konrad, B., Morel, P. et al. Laparoscopic versus open sigmoid resection for diverticulitis: long-term results of a prospective, randomized trial. Surg Endosc 25, 3373–3378 (2011). https://doi.org/10.1007/s00464-011-1728-8
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DOI: https://doi.org/10.1007/s00464-011-1728-8