Anastomoticleakisoneofthemostdevastatingcomplicationsof restorativerectalresectionandisassociatedwithconsiderablemorbidity andmortalityaswellasincreasedLOSandhealthcarecosts.The laparoscopicapproachtoTMEandrestorativerectalresectiondoesnot appeartoincreasetheincidenceofpostoperativeanastomoticleak.A recentmeta-analysisincludingsixrandomizedcontrolledtrialsdidnot findanysignificantdifferenceintheincidenceofpostoperative anastomoticleakbetweenopenandlaparoscopicLAR.Theauthors utilizemechanicalbowelpreparationwithPOantibioticsonallLARs basedonastudyfromtheauthors’institutionofNSQIPdatathatfound theincidenceofanastomoticleaktobesignificantlylowerinpatients withapreoperativebowelprepcomparedtothosewithnobowelprep (2.8%vs.5.7%).TheauthorsalsofrequentlyutilizeDLIforpatients undergoingcoloanalanastomosis,particularlyafterpreoperative chemoradiation.AlthoughtheissueofwhetherDLIreducestheincidence ofanastomoticleaksremainscontroversial,itseemscleartheDLIlessens theclinicalseverityofanastomoticleakwhenitoccurs.Theevaluation andmanagementofanastomoticleakagedoesnotdifferbetween laparoscopicandopenapproachesandhasbeenwelldescribed elsewhere.OptionsmayincludeIVantibioticsalone,CT-guided percutaneousdrainageofpelvicfluidcollections,andlaparoscopicDLIif