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AL was more likely after (extended) left hemicolectomy\/sigmoidectomy (OR 3.771; 95% CI 1.17\u201312.154;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.026) and in combination with perioperative administration of blood transfusions (OR 2.926; 95% CI 1.013\u20138.455;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.047) in colon surgery. BMI\u2009\u2265\u200930\u00a0kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      significantly increased the probability of AL (OR 7.136; 95% CI 2.248\u201312.651;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) in rectal cancer surgery. Preoperative oral antibiotics, mainly in combination with mechanical bowel preparation, were associated with a reduced AL rate in both entities (OR 0.199, 95% CI 0.064\u20130.617;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005 for colon; OR 0.278, 95% CI 0.078\u20130.985;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.047 for rectal cancer), regardless the antibiotic regimen used. The number required for treatment was calculated as 15.94.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our study, reflecting daily clinical practice, confirmed known risk factors (left-sided resection, perioperative blood transfusions, obesity) and identified oral antibiotics as the only protective factor against AL. The application of a single or double oral dose of two antibiotics is safe and pragmatic and should be implemented in standard operative procedures for colorectal cancer surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00423-025-03953-9","type":"journal-article","created":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T02:54:56Z","timestamp":1767927296000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Risk and protective factors for anastomotic insufficiency in elective colon and rectal cancer resections \u2013 a multivariate analysis with over 700 patients"],"prefix":"10.1007","volume":"411","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0968-3560","authenticated-orcid":false,"given":"Undine Gabriele","family":"Lange","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Mehdorn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gudula","family":"Keller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anja","family":"Willing","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holger","family":"Nitzsche","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leif Christian","family":"Wagner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ines","family":"Gockel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boris","family":"Jansen-Winkeln","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soeren Torge","family":"Mees","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sigmar","family":"Stelzner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,9]]},"reference":[{"issue":"8","key":"3953_CR1","doi-asserted-by":"publisher","first-page":"e2890","DOI":"10.1097\/MD.0000000000002890","volume":"95","author":"JS Park","year":"2016","unstructured":"Park JS, Huh JW, Park YA, Cho YB, Yun SH, Kim HC, Lee WY (2016) Risk factors of anastomotic leakage and long-term survival after colorectal surgery. 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