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This study aimed to identify risk-factors of mortality after colorectal cancer resection in France, with special reference to the impact of laparoscopic approach.Data were extracted from the French national health service database (Programme de Médicalisation des Syste`mes d'Information, PMSI). All patients who underwent colorectal resection for colorectal cancer between 2006 and 2008 in France were included. A multivariate analysis evaluating risk-factors for post-operative 30-day mortality was performed including the following factors: age, gender, tumour location, associated co-morbidities, emergency surgery, synchronous liver metastasis, and surgical approach.A total of84 524 patients were included: 22 359 with laparoscopic approach (27%) and 62 165 with open approach (73%). From 2006 to 2008, laparoscopic approach rate increased from 23% to 26%. Postoperative 30-day mortality was 5.0%. In multivariate analysis, independent factors influencing mortality were: age ≥ 70 years (OR: 3.3), respiratory comorbidity (3.2), vascular comorbidity (2.7), synchronous liver metastasis (2.7), neurologic comorbidity (1.8), and laparoscopic approach (0.6).For the first time, a national survey including all patients undergoing colorectal resection for cancer during a 3-year period suggested that laparoscopic approach could significantly reduce post-operative mortality. This result might support better acceptance and widespread of laparoscopic approach in colorectal cancer.