Laparoscopic surgery is associated with reduced long-term reoperation risk in Crohn's disease.
5 affiliations
- 1Division of Visceral Surgery, Department of General Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
- 2Department of Medical Statistics, Medical University of Vienna, Vienna, Austria.
- 3Division of Gastroenterology and Hepatology, Dept. of Medicine III, Medical University of Vienna, Vienna, Austria.
- 4Division of Visceral Surgery, Department of General Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria. [email protected].
- 5Department of Colorectal Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK. [email protected].
Abstract
Background
Minimally invasive surgery (MIS) improves short-term outcomes in Crohn's disease (CD), but its impact on long-term surgical recurrence is uncertain.Methods
The objective of this study was to assess risk factors for surgical recurrence after intestinal resection for CD, with emphasis on surgical approach. A retrospective single-centre study of patients undergoing elective intestinal resection for CD between 1995 and 2020 was conducted. Demographics, disease features, surgical details and complications were analysed. Recurrence was assessed using Kaplan-Meier and Cox regression.Results
A total of 641 patients were included, with a mean follow-up of 12.4 years. Mean age at surgery was 38.3 years; mean disease duration was 11.5 years. Laparoscopy was performed in 270 patients, and open surgery in 371. Cumulative recurrence was 25% at 25 years. Kaplan-Meier analysis demonstrated lower cumulative surgical recurrence rates following laparoscopic compared with open surgery (log-rank p = 0.010). In multivariate Cox regression analysis, open surgery was associated with a higher hazard of surgical recurrence (HR 1.76, 95% CI 1.14-2.69), alongside smoking, female sex and microscopically inflamed resection margins. Severe perioperative complications (7.0% overall; 3.3% laparoscopic versus 9.7% open) did not influence recurrence (p = 0.574).Conclusions
Laparoscopic surgery was associated with longer reoperation-free survival and a lower hazard of surgical recurrence in this long-term cohort. Surgical approach may represent a potentially modifiable factor in optimising long-term outcomes in Crohn's disease, alongside smoking cessation and achieving microscopically clear resection margins.
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BibTeX
@article{schlager2026laparoscopic,
title = {{Laparoscopic surgery is associated with reduced long-term reoperation risk in Crohn's disease.}},
author = {L Schlager and M Hamidi and T Dengler and B Fallmann and C Krall and P Schreiner and W Reinisch and A Hansmann and M Bergmann and A Stift and L W Unger},
journal = {Techniques in coloproctology},
year = {2026},
month = jul,
doi = {10.1007/s10151-026-03389-3},
url = {https://europepmc.org/article/MED/42902052},
note = {CC BY},
}
RIS
TY - JOUR
TI - Laparoscopic surgery is associated with reduced long-term reoperation risk in Crohn's disease.
AU - L Schlager
AU - M Hamidi
AU - T Dengler
AU - B Fallmann
AU - C Krall
AU - P Schreiner
AU - W Reinisch
AU - A Hansmann
AU - M Bergmann
AU - A Stift
AU - L W Unger
PY - 2026
DA - 2026/07/23
JO - Techniques in coloproctology
DO - 10.1007/s10151-026-03389-3
UR - https://europepmc.org/article/MED/42902052
AB - Background Minimally invasive surgery (MIS) improves short-term outcomes in Crohn's disease (CD), but its impact on long-term surgical recurrence is uncertain.Methods The objective of this study was to assess risk factors for surgical recurrence after intestinal resection for CD, with emphasis on surgical approach. A retrospective single-centre study of patients undergoing elective intestinal resection for CD between 1995 and 2020 was conducted. Demographics, disease features, surgical details and complications were analysed. Recurrence was assessed using Kaplan-Meier and Cox regression.Results A total of 641 patients were included, with a mean follow-up of 12.4 years. Mean age at surgery was 38.3 years; mean disease duration was 11.5 years. Laparoscopy was performed in 270 patients, and open surgery in 371. Cumulative recurrence was 25% at 25 years. Kaplan-Meier analysis demonstrated lower cumulative surgical recurrence rates following laparoscopic compared with open surgery (log-rank p = 0.010). In multivariate Cox regression analysis, open surgery was associated with a higher hazard of surgical recurrence (HR 1.76, 95% CI 1.14-2.69), alongside smoking, female sex and microscopically inflamed resection margins. Severe perioperative complications (7.0% overall; 3.3% laparoscopic versus 9.7% open) did not influence recurrence (p = 0.574).Conclusions Laparoscopic surgery was associated with longer reoperation-free survival and a lower hazard of surgical recurrence in this long-term cohort. Surgical approach may represent a potentially modifiable factor in optimising long-term outcomes in Crohn's disease, alongside smoking cessation and achieving microscopically clear resection margins.
SN - 1123-6337
SN - 1128-045X
ER -