Higher ASA scores, steroid use, and blood transfusions significantly raise the risk of anastomotic leaks during simultaneous resections of colon cancer and liver metastasis.

• 5.3% of patients experienced anastomotic leaks post-surgery.
• Higher ASA score, chronic steroid use, and intraoperative blood transfusion were identified as key risk factors.

Surgeons should consider fecal diversion or staged procedures for high-risk patients to reduce complications.

• Major hepatectomies also showed increased leak risk.