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Laparoscopic sigmoid resection hasproven short term benefits, but there are few data on long term outcome, quality of life and function.One hundred and thirteen patients were randomized to laparoscopic (LAP group, N = 59) and open (OP group, N = 54) sigmoid resection for diverticulitis. They filled in the Gastrointestinal Quality of Life Index (GIQLI) questionnaire at a median follow up of 28 months after surgery.Incisional hernia was detected in 5 (9.2%) patients in the OP group versus 7 (11.8%) in the LAP group (P = 0.76). Overall satisfaction with the operation on a scale of 0 (very poor) to 10 (excellent) was 9 (range 2-10) in the OP versus 9 (range 2-10) in the LAP group (P = 0.74). The median GIQLI score was 115 (57-144) in the OP group and 107 (61-133) in the LAP group (P = 0.23). Overall satisfaction with the cosmetic aspect of the scar on a scale of 0 to 10 was 8 (range 1-10) in the OP versus 10 (range 2-10) in the LAP group (P = 0.01).Both open and laparoscopic approaches for sigmoid resection achieve excellent results in terms of gastrointestinal function, and patient satisfaction. Significant benefits of laparoscopic surgery are restricted to the cosmetic result.