在结直肠癌急症环境下，微创手术（MIS）的安全性和可行性一直存在争议。我们旨在比较美国外科医师协会国家外科质量改进计划（ACS-NSQIP）数据库中结直肠癌急症情况下，MIS与传统手术技术的术后结果。我们从2012年至2019年ACS-NSQIP数据集中包含了接受结直肠癌急症结肠切除术的患者。“我们使用了倾向性评分匹配对MIS与传统手术的术后短期并发症、死亡率、短期肿瘤学结果和次要结果进行了比较。然后，我们使用线性回归分析评估了MIS与传统手术的发展趋势。 我们检查了5544例患者（传统手术4070例，MIS 1474例），并在倾向性评分匹配后选择了1352例患者进行术后结果分析（传统手术676例，MIS 676例）。在匹配队列中，传统手术组的死亡率明显高于MIS组（传统手术6.95% vs MIS 3.99%，OR 1.8，p=0.023）。两组的吻合口漏率相当（传统手术4.46% vs MIS 4.02%，OR 1.12，p=0.787）。传统手术后的肺部并发症明显更高（传统手术10.06% vs MIS 4.73%，OR 2.25，p<0.001）。传统手术患者的肠梗阻率明显更高（传统手术29.08% vs MIS 19.94%，p<0.001）。传统手术后患者住院时间平均比MIS手术多1天（p<0.001）。早期肿瘤（N0和T1/T2，n=289）的MIS比例在7年期间未显著改变（p=0.597，比率=-0.065%/年）；然而，晚期肿瘤（N1或T3/T4，n=4359）的MIS利用率每年增加2.06%（p<0.001）。 本研究表明，在接受结直肠癌急症结肠切除术的患者中，MIS与传统手术相比，术后结果更好，而且不影响肿瘤学结果。在匹配队列中，MIS与较低的死亡率、肺部并发症、肠梗阻率和较短的术后住院时间相关。© 2023 Springer Nature Switzerland AG.

The safety and feasibility of minimally invasive surgery (MIS) in the setting of colorectal cancer emergencies have been debated. We sought to compare postoperative outcomes of MIS with open techniques in the setting of colorectal cancer emergencies from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database.We included patients undergoing colectomy for colorectal cancer emergency between 2012 and 2019 "2012-2019" from the ACS-NSQIP dataset. We compared short-term morbidity, mortality, short-term oncological outcomes, and secondary outcomes for MIS vs open colectomies using propensity score matching. We then evaluated the trends of MIS versus open colectomies using linear regression analysis.We examined a total of 5544 patients (open n = 4070; MIS n = 1474) and included 1352 patients for our postoperative outcome analyses after propensity score matching 1:1 (open n = 676; MIS n = 676). Within the matched cohort, mortality was significantly higher in the open group (open 6.95% vs MIS 3.99%, OR 1.8, p = 0.023). Anastomotic leak rates were comparable between the  two groups (open 4.46% vs MIS 4.02%, OR 1.12, p = 0.787). Pulmonary complications were significantly higher after open surgery (open 10.06% vs MIS 4.73%, OR 2.25, p < 0.001). Rates of ileus were significantly higher amongst open patients (open 29.08% vs MIS 19.94%, p < 0.001). Patients stayed on average 1 day longer in the hospital after open surgery (p < 0.001). Rates of MIS for early tumors (N0 and T1/T2, n = 289) did not significantly change over 7 years (p = 0.597, rate = - 0.065%/year); however, utilization of MIS for late tumors (N1 or T3/T4, n = 4359) increased by 2.06% per year (p < 0.001).This study demonstrates that MIS was associated with superior postoperative outcomes compared to open surgery without compromising oncological outcomes in patients undergoing emergency colectomy for colon cancer. Within the matched cohort, MIS was associated with lower rates of mortality, pulmonary complications, ileus, and shorter postoperative length of stay.© 2023. Springer Nature Switzerland AG.