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For patients undergoing elective intestinal resection for Crohn disease (CD), cumulative surgical recurrence rates are lower with laparoscopic versus open surgery, according to a study published online July 23 in Techniques in Coloproctology.

Lukas Schlager, M.D., from the Medical University of Vienna in Austria, and colleagues conducted a retrospective study involving patients undergoing elective intestinal resection for CD between 1995 and 2020 to examine risk factors for surgical recurrence. Data were included for 641 patients followed for a mean of 12.4 years.

Overall, 270 patients underwent laparoscopy and 371 underwent open surgery. At 25 years, cumulative recurrence was 25%. The researchers found that cumulative surgical recurrence rates were lower following laparoscopic versus open surgery in a Kaplan–Meier analysis. Open surgery was associated with an increased risk for surgical recurrence in a multivariate Cox regression analysis (hazard ratio, 1.76), as were smoking, female sex and microscopically inflamed resection margins. Severe perioperative complications (7.0% overall) were not associated with recurrence.

"Although causal inference is limited by the observational design, the consistency of Kaplan–Meier and Cox regression findings over a 25-year period suggests that the surgical approach may represent a modifiable factor influencing long-term outcomes, alongside established risk factors such as smoking and resection margin inflammation," the authors write.

L. , Laparoscopic surgery is associated with reduced long-term reoperation risk in Crohn's disease, Techniques in Coloproctology (2026).

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