**3. Consequences of short- and long-term colorectal anastomotic leakage (CAL)**

The most feared complication following intestinal resection is anastomotic leakage. The short consequences of CAL are variables. This spectrum ranges from a small-contained leak without sepsis to a patient with peritonitis and septic shock and patient's death. Once the leak is established, its consequences depend on the presence and interaction of multiple factors. Among them are the size of the leak, the level of the anastomosis, the pathology that led to the surgery, the speed and ability to control the source of contamination, the patient's co-morbidities, the presence of sepsis, and the patient's immune response to sepsis. Thus, we may be facing a small leak controllable with antibiotics/percutaneous drainage, only with prolonged hospitalization or readmission, up to four-quadrant peritonitis with septic shock that implies not only surgery but also the support of various organs and systems in an environment of intensive care.

When we speak about the long-term consequences of CAL, we are referring to the possible reduction in oncological survival [7, 8] or implications in anastomosis functionality, which may be partially or entirely compromised depending on the severity of the CAL, and anastomosis location [9]. Ishizuka meta-analysis demonstrates a significantly decreased 5-year OS in patients with CRC who had CAL compared with patients with CRC who did not have CAL [7].
