79 International Consensus on Reporting colorectal Anastomotic Leaks (CoReAL) A2. Detailed reporting framework a. Preoperative reporting elements Modifiable risk factors Other risk factors Mechanical bowel preparation A lcohol: ……/ week A ctive smoker: …… cigarettes / day S erum albumin level < 30 days before the surgery: …… D rop down menu ͳ BMI ͳ Gender: male / female ͳ ASA score ͳ Diabetes: yes (Hba1c:….) / no ͳ Cardiovascular disease: yes / no ͳ Chronic renal failure or insufficiency: yes / no ͳ Chronic steroid use: yes / no ͳ Clinical T-stage: T1 or T2 (not advanced) / T3 or T4 (advanced) ͳ Tumor size: > 5cm / < 5 cm ͳ Tumor location: right / transverse / left / rectal ͳ Complicated tumor: yes (perforation / obstruction) / no ͳ Neoadjuvant therapy: preop chemotherapy / radiotherapy / long course chemotherapy / short course chemotherapy / immunotherapy Yes No Was the patient referred to a stoma therapist preoperatively? Was the potential need of a postoperative/ permanent stoma discussed? Preoperative oral antibiotics Yes No Yes No Yes, Specify: …… No 3
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