Surgical recurrence less frequent with laparoscopic surgery for Crohn disease

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.

Several authors disclosed ties to the biopharmaceutical industry.

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