A case-control study of laparoscopic versus open sigmoid colectomy for diverticulitis

Laparoscopic sigmoid colectomy (LSC) for diverticular disease accounts for a limited number of laparoscopic colon cases performed nationally because o f the technical challenge it presents. Our objective was to determine the f easibility and impact of the laparoscopic approach in elective sigmoid cole ctomy for diverticular disease and to compare these results with those of t he open approach. Twenty elective laparoscopic sigmoid colectomies (LSCs) w ere performed for diverticulitis between April 1992 and July 1999 at a univ ersity-affiliated urban hospital. A case-control study was performed compar ing LCS with a matched control group of conventional open sigmoidectomies. Fourteen of 20 sigmoidectomies were successfully completed laparoscopically . The mean operative time for LSC was similar to that for open sigmoid cole ctomy (251 vs 243 minutes). There was earlier return to oral intake in the LSC group (1 vs 5 days; P < 0.001). The mean length of stay was significant ly shorter (P = 0.029) in LSC (4.8 days) versus open sigmoid colectomy (7.8 days). Conversion to open sigmoidectomy extended hospital stay to 8.16 day s. The overall complication rate was 10 per cent in both groups. We conclud e that LSC can be performed effectively and with a low complication rate fo r diverticular disease. LSC provides the benefit of quicker return of bowel function and shorter hospitalization.