**9. CAL detection**

Detection of anastomotic leak and assessment of its severity is crucial. Anastomotic leakage has a wide range of clinical features ranging from radiologicalonly findings to peritonitis and sepsis with multi-organ failure. Timely diagnosis of CAL is paramount to limit related morbidity and mortality. Thus, it is essential to invest in the early identification of colorectal anastomotic dehiscence. Both clinical criteria parameters (clinical condition and abdominal pain) seem to be useful early markers for this condition, producing the best overall diagnostic accuracy of the parameters analyzed. C-reactive protein and procalcitonin have been identified as early analytical predictors of anastomotic leakage starting from postoperative days (Second to third postoperative day). Nevertheless, an abdominal-pelvic computed tomography scan is still the gold standard for diagnosis [122, 123]; however, a CT scan can be insufficiently accurate for CAL detection due to its high false negative rate (around 30%) [124]. Several treatments can be adopted for anastomotic leakage. However, there is not a universally accepted flowchart for the management, which should be individualized based on the patient's general condition, anastomotic defect size, location, indication for primary resection, and presence of the proximal stoma.
