While much has been published in the literature regarding the risks for anastomotic leak, evidence-based tools to aid surgeons in deciding whether or not to create a defunctioning stoma after left-sided colorectal surgery are lacking. In an article recently published in the Journal of Surgical Research, Dekker et al. report a novel Colon Leakage Score (CLS) that may help guide surgeons in making this decision [11. The CLS estimates the probability of a clinically significant anastomotic leak from left-sided colorectal surgery defined as left colectomy, sigmoid resection, or rectal resection. The CLS was derived from the combination of a literature review and Delphi method and validated in a single-center retrospective study. The score is comprised of 11 weighted patient and operative risk factors, yielding a value between 0 and 43. Using receiver operating characteristic curves and logistic regression models, the CLS can be used to predict the probability of a clinically significant anastomotic leak in individual patients. Among the population studied, a CLS value of 11 corresponded to a 3% risk of leak.
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