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To evaluate the role ofprocalcitonin (PCT) and C-reactiveprotein (PCR) in the earlyprediction of anastomotic leakage (AL) in colorectal surgery.A series of 212 patients undergone colorectal surgery at our specialized Unit was analyzed. The following data were collected: demographic, surgical, ASA, POSSUM and morbidity. During the first five postoperative days, the value of PCT, PCR, leucocytes, platelets and vital signs were daily evaluated. ROC curve was used for statistical analysis.AL was detected in 17 (8.0%) patients; 8 (3.8%) of them had a major (need for drainage or reoperation) AL. None of the variables evaluated were reliable indicators for early detection of AL (maximum area under the curve (AUC) < 0.75). However, considering only major AL, PCT (at day 4) and PCR (at day 3) resulted to be reliablepredictors (P < 0.0001 and P = 0.003 respectively, AUC = 0.893 and 0.827 respectively). In particular PCT, at a cut-off value of 0.57 ng/ml, showed to have a 87.5% sensibility and a 80.5% specificity.The most reliable variable forprediction of AL is PCT. An elevated PCT value at the 4th postoperative should dictate a careful evaluation of the patient before discharge.