Title: Risk assessment of rectal anastomotic leakage (RAREAL) after DIXON in non-
emergency patients with rectal cancer: a retrospective study
Version: 0 Date: 25 Oct 2022
Reviewer:  Giovanni Tomasicchio
Reviewer's report:
In this retrospective study, the authors analyzed the preoperative and intraoperative risk factors
for anastomosis leak after Dixon surgery in rectal cancer. These risk factors were then used to
establish a risk assessment of rectal anastomotic Leak (RAREAL) model.
I have several questions/comments for the authors:
- Were there statistically significant differences between the two groups (model and validation)?
- What type of bowel preparation was done? Was it the same for all the patients? Please precise it.
- Please precise what you mean by “active preoperative preparation”.
- In this retrospective analysis you have analysed 604 consecutive patients who had undergone
DIXON for rectal cancer but is not clear if all the patients have had a prophylactic diverging
stoma or nor. Please specify it.
- Was an intraoperative leak test done in  patients without a prophylactic diverging stoma?
- Did the linear cutting closure device used for rectal resection, and circular stapler used for
rectal anastomosis, were the same devices for all the patients, or you used different companies?
Moreover, did the circular stapler was a double-rows or triple-rows?
Title: Risk assessment of rectal anastomotic leakage (RAREAL) after DIXON in non-
emergency patients with rectal cancer: a retrospective study
Version: 0 Date: 25 Oct 2022
Reviewer:  Giovanni Tomasicchio
Reviewer's report:
In this retrospective study, the authors analyzed the preoperative and intraoperative risk factors
for anastomosis leak after Dixon surgery in rectal cancer. These risk factors were then used to
establish a risk assessment of rectal anastomotic Leak (RAREAL) model.
I have several questions/comments for the authors:
- Were there statistically significant differences between the two groups (model and validation)?
- What type of bowel preparation was done? Was it the same for all the patients? Please precise it.
- Please precise what you mean by “active preoperative preparation”.
- In this retrospective analysis you have analysed 604 consecutive patients who had undergone
DIXON for rectal cancer but is not clear if all the patients have had a prophylactic diverging
stoma or nor. Please specify it.
- Was an intraoperative leak test done in  patients without a prophylactic diverging stoma?
- Did the linear cutting closure device used for rectal resection, and circular stapler used for
rectal anastomosis, were the same devices for all the patients, or you used different companies?
Moreover, did the circular stapler was a double-rows or triple-rows?
Please review this paper.
user
Title: Risk assessment of rectal anastomotic leakage (RAREAL) after DIXON in non-
emergency patients with rectal cancer: a retrospective study
Version: 0 Date: 25 Oct 2022
Reviewer:  Giovanni Tomasicchio
Reviewer's report:
In this retrospective study, the authors analyzed the preoperative and intraoperative risk factors
for anastomosis leak after Dixon surgery in rectal cancer. These risk factors were then used to
establish a risk assessment of rectal anastomotic Leak (RAREAL) model.
I have several questions/comments for the authors:
- Were there statistically significant differences between the two groups (model and validation)?
- What type of bowel preparation was done? Was it the same for all the patients? Please precise it.
- Please precise what you mean by “active preoperative preparation”.
- In this retrospective analysis you have analysed 604 consecutive patients who had undergone
DIXON for rectal cancer but is not clear if all the patients have had a prophylactic diverging
stoma or nor. Please specify it.
- Was an intraoperative leak test done in  patients without a prophylactic diverging stoma?
- Did the linear cutting closure device used for rectal resection, and circular stapler used for
rectal anastomosis, were the same devices for all the patients, or you used different companies?
Moreover, did the circular stapler was a double-rows or triple-rows?
assistant