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Re: ‘Clinical impact of leakage in patients with handsewn vs stapled anastomosis after right hemicolectomy: a retrospective study’

We read with interest this paper exploring outcomes from anastomotic leak (AL) after right hemicolectomy in which AL was diagnosed in 116/961 patients (12%). Whilst the authors do acknowledge this as particularly high, we feel several points merit further discussion. First, diagnosis of leak was heavily reliant on C-reactive protein (CRP) level with 'clinical or radiological examination' performed in any patient with CRP>125 mg/l on Day 4. Importantly, single CRP values have limited discriminatory value [1], while radiological findings such as peri-anastomotic oedema and/or pneumoperitoneum are not unusual at early post-operative time-points which may have inflated the reported leak rate.