Antithrombotic therapy significantly increases the risk of anastomotic leakage after colorectal surgery, which is critical for patient management.

• 8.8% of patients developed anastomotic leakage, with antithrombotic therapy linked to a 2.10 times greater risk.
• Other risk factors include previous colorectal surgery (1.69 times), male sex (1.99 times), and anastomosis < 5 cm from the anal verge (2.28 times).

Surgeons should consider these factors during patient selection and pre-operative assessments.