“Anastomotic leak (AL) represents a dreaded complication following colorectal surgery, with a prevalence of 1-19 per cent. There remains a lack of consensus regarding factors that may predispose to AL and the relative risks associated with them. The objective was to perform a systematic review of the literature, focusing on the role of preoperative, intraoperative and postoperative factors in the development of colorectal ALs.”

“ALs remain a huge challenge despite many surgical and technological advances. Although controversial, there is evidence for improved outcomes with the creation of subspecialization and centralization of services in high-volume centres. Furthermore, continued high-quality research is of paramount importance to reduce the risk and sequelae associated with ALs. Improved early identification aided by use of scoring systems and imaging is essential for the successful management of ALs. Finally, more research focusing on intraoperative blood
flow assessment, combined with goal-directed fluid therapy, is warranted. Collaboration between research units across the globe to power studies adequately will be the key to success in reducing the burden of this potentially catastrophic complication.”

McDermott, F D et al. “Systematic review of preoperative, intraoperative and postoperative risk factors for colorectal anastomotic leaks.” The British journal of surgery vol. 102,5 (2015): 462-79.