351 Impact topic. Currently, we are in the final stages of achieving a universally accepted reporting framework for colorectal AL by gaining more feedback from members from different surgical societies all over the world. In parallel, we are working on a radiological reporting framework too. We are confident that the forthcoming work, resulting from this collective effort, will be embraced by researchers and clinicians worldwide. Ideally, better reporting practices contribute to the generation of robust data on colorectal surgical outcomes, supporting high-level evidence research and health initiatives aimed at reducing the overall burden of colorectal disease and improving population health. Additionally, the work presented in part III highlighted the importance of incorporating patients’ perspectives after leak development into future research. By synthesizing existing evidence on biomarkers associated with PM and analyze our own tumors, part IV contributes to the ongoing dialogue among healthcare professionals and researchers regarding personalized treatment approaches and patient care strategies. The observed safety concerns of a potential preventive treatment in the form of a hydrogel additionally underscore the importance of further optimization and research. SUSTAINABILITY Human health and the health systems we rely on face growing threats from the environmental crise, including climate change 9. Ironically, the healthcare sector ranks among the one of the largest service industries with a significant carbon footprint, in which the operating room is particularly a resource-intensive component of the system 9, 10. Surgical care demands substantial resources within healthcare, including costly and resource-intensive equipment, water and energy for sterilization procedures, advanced technology, and necessary life support systems. These processes consume significant amounts of energy and materials, while also generating substantial waste 10. By trying to reduce the occurrence and impact of AL and PM, fewer resources such as hospital stays, medications, and surgeries are needed, leading to decreased energy consumption and waste production associated with healthcare facilities. Less surgical interventions and medical treatments mean reduced environmental impact associated with healthcare services, including transportation, equipment manufacturing, and hospital operations. Additionally, it leads to better patient health and reduced need for ongoing medical care, resulting in lower overall healthcare-related environmental impact over time. Lastly, improving the landscape of AL and PM frees up healthcare resources for other patients and medical needs, promoting efficient resource allocation and reducing strain on the healthcare system, which can indirectly contribute to environmental sustainability. Overall, preventing complications after colorectal surgery not only benefits patient health but also contributes to reducing the environmental footprint of healthcare systems, thereby improving environmental sustainability. 15
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