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Laparoscopic versus open sigmoid resection for diverticulitis: long-term results of a prospective, randomized trial

Gervaz, Pascal ; Mugnier-Konrad, Béatrice ; Morel, Philippe ; Huber, Olivier ; Inan, Ihsan

In: Surgical Endoscopy, 2011, vol. 25, no. 10, p. 3373-3378

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    Titre
    • Laparoscopic versus open sigmoid resection for diverticulitis: long-term results of a prospective, randomized trial
    Auteur
    • Gervaz, Pascal. Department of Surgery, Geneva University Hospital and Medical School, Geneva, Switzerland
    • Mugnier-Konrad, Béatrice. Department of Surgery, Geneva University Hospital and Medical School, Geneva, Switzerland
    • Morel, Philippe. Department of Surgery, Geneva University Hospital and Medical School, Geneva, Switzerland
    • Huber, Olivier. Department of Surgery, Geneva University Hospital and Medical School, Geneva, Switzerland
    • Inan, Ihsan. Department of Surgery, Geneva University Hospital and Medical School, Geneva, Switzerland
    Type de document
    • Postprint
    Identifiant OAI-PMH
    • oai:doc.rero.ch:318576
    Summary
    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)