The role of minimally invasive surgery (MIS) to treat clinically T4 (cT4) colorectal cancer (CRC) remains uncertain and deserves further investigation. A retrospective cohort study was conducted between September 2006 and March 2019 recruiting patients diagnosed as cT4 CRC and undergoing MIS at a university hospital and its branch. Patients’ demography, clinicopathology, surgical and oncological outcomes, and radicality were analyzed. A total of 128 patients were recruited with an average follow-up period of 33.8 months. The median time to soft diet was 6 days, and the median postoperative hospitalization periods was 11 days. The conversion and complication (Clavien–Dindo classification ≥ II) rates were 7.8% and 27.3%, respectively. The 30-day mortality was 0.78%. R0 resection rate was 92.2% for cT4M0 and 88.6% for pT4M0 patients. For cT4 CRC patients, the disease-free survival and 3-year overall survival were 86.1% and 86.8% for stage II, 54.1% and 57.9% for stage III, and 10.8% and 17.8% for stage IV. With acceptable conversion, complication and mortality rate, MIS may achieve satisfactory R0 resection rate and thus lead to good oncological outcomes for selected patients with cT4 CRC.

微创手术（MIS）在临床上治疗T4（cT4）大肠癌（CRC）的作用仍然不确定，值得进一步研究。在2006年9月至2019年3月之间进行了一项回顾性队列研究，招募了被诊断为cT4 CRC并在大学医院及其分支机构接受MIS的患者。分析了患者的人口统计学，临床病理学，手术和肿瘤学结局以及根治性。总共招募了128例患者，平均随访时间为33.8个月。软饮食的中位时间为6天，术后住院期间的中位时间为11天。转换和并发症（Clavien-Dindo分类≥II）的发生率分别为7.8％和27.3％。30天死亡率为0.78％。cT4M0患者的R0切除率为92.2％，pT4M0患者的R0切除率为88.6％。对于cT4 CRC患者，II期的无病生存率和3年总生存率分别为II期的86.1％和86.8％，III期的为54.1％和57.9％，IV期的为10.8％和17.8％。有了可接受的转化率，并发症和死亡率，MIS可以达到令人满意的R0切除率，从而为选定的cT4 CRC患者带来良好的肿瘤学结果。