This study examines risk factors for anastomotic leakage (AL) following radical colorectal cancer surgery and explores its associations with postoperative recovery, delays in adjuvant chemotherapy, and long-term oncological outcomes. Among 200 patients, 22 developed AL, which was graded according to the ISREC criteria. By integrating perioperative risk factors, short-term outcomes, and long-term survival, the study addresses a clinically relevant question. Its main contribution lies in this integrated clinical analysis rather than methodological innovation. The article introduces the APOS framework and discusses critical thinking in relation to variable selection, statistical analysis, and clinical decision-making. However, its incremental value over conventional clinical analyses and its practical contribution to prediction or clinical decisions are not clearly demonstrated. The novelty attributable to this framework therefore remains uncertain. Several statistical reporting inconsistencies warrant clarification. In Table 1, neoadjuvant therapy is reported with χ² = 2.512 and P = 0.043, while diverting stoma formation is reported with χ² = 1.640 and P = 0.037. These statistics do not correspond to the reported P values under the conventional Pearson chi-square test. Since the table accommodates χ², t, and Z statistics, the specific tests used require confirmation. In Table 2, the OR for diverting stoma formation is 0.468 (95% CI, 0.166–1.322), with a Wald χ² statistic of 2.286 and a reported P value of 0.043. Under a conventional two-sided Wald test with one degree of freedom, the statistic corresponds to a P value of approximately 0.13, and the confidence interval includes the null value of 1. These results are not mutually consistent. Without raw data and complete statistical output, the cause cannot be established, and the discrepancies should be regarded as potential reporting problems rather than proof of broader analytical errors. The survival analysis methods also require clarification. OS is defined as the time from surgery to death from any cause or last follow-up, and death is included as an event in the DFS definition. However, the Methods section states that patients who died within 12 months after surgery were censored at the time of death. If deaths were actually coded as censored observations rather than events, the survival estimates could be affected. The text alone, however, cannot establish whether the actual event coding was incorrect. In addition, only 22 AL events occurred, yet multiple factors were included in the multivariable logistic regression model, raising concerns about overfitting and unstable estimates. The association between diverting stoma formation and AL may also be affected by confounding by indication. These findings should therefore be interpreted cautiously and should not be taken as establishing causality. Other reporting issues include unclear presentation of the estimated number of new colorectal cancer cases in China in 2022, inconsistent descriptions of the criteria used to define AL, and wording referring to a systematic review despite the retrospective cohort design. The alignment between some claims about diverting stoma formation and the outcomes addressed in the cited references also warrants verification, particularly the distinction between preventing AL and mitigating its clinical consequences. Overall, the study provides clinically relevant observational evidence by linking AL risk factors with postoperative outcomes and long-term prognosis. However, statistical reporting inconsistencies, ambiguity in the survival analysis methods, and the limited number of AL events constrain the interpretability and generalizability of its findings. Further statistical verification and validation in independent cohorts are needed before the results can be confidently applied in clinical practice.