51 Quality of reporting on anastomotic leaks in colorectal trials: A systematic review reporting and grading of colorectal AL is highlighted. This uniform process would facilitate quality assurance in the reporting of diagnostic elements, enable transparant of study results and reliable interpretation of meta-analyses. The development of a general outcome AL set may be helpful to tackle further reporting gaps. Consequently, the findings of this study may inform the development of consensus framework for the reporting and grading of AL after CRC surgery. CONCLUSION This systematic review highlights substantial heterogeneity in the elements used to define colorectal AL across high level evidence literature, reflecting the need for a widely accepted framework that can guide definition, grading, and reporting of AL. Standardized reporting of AL is essential for mitigating delays in diagnosis and treatment, promoting the development of treatment guidelines, and addressing existing shortcomings. CONTRIBUTORS, ACKNOWLEDGEMENTS AND STATEMENTS CoReAL collaborative: Michel Adamina, Alberto Arezzo, Mahdi Al-Taher, Tan Arulampalam, Saba Balvardi, Himani Bhatt, Marta Botti, Stephanie O. Breukink, David A. Clark, Freek Daams, Jennifer S. Davids, Anse De Sadeleer, Abe Fingerhut, Zoe Garoufalia, Anke H.C. Gielen, Mukesh G. Harisinghani, Roel Hompes, Neil H. Hyman, Mehraneh D. Jafari, John T. Jenkins, Audrey C.H.M. Jongen, Deborah S. Keller, Samuel H. Lai, Jérémie H. Lefevre, Bibi Martens, Justin A. Maykel, Jeongyoon Moon, Nariaki Okomoto, Ian Paquette, Gianluca Pellino, Sherief F. Shawki, Benjamin D. Shogan, Chelliah Selvasekar, Simon Siu-Man Ng, Jasper Stijns, Patricia Tejedor, William Tzu-Liang Chen, Yu-Ting T van Loon, Christiaan van Der Leij, Steven D. Wexner, Elizabeth Wick, Marina Yiasemidou. We would like to thank Gregor Franssen who was involved as a professional clinical librarian to ensure an appropriate search strategy. This work was funded by the American Society of Colon and Rectal Surgeons (ASCRS) Research Foundation Anastomotic Leak Grant. 2
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