Background: Obstructive ileus and peritonitis are the most frequent complication of colorectal cancer, manifested in 8-40% cases. Anastomotic leakage (AL) is a fatal complication in colorectal surgery. In our study, we aim to analyse the safety, outcomes in patients with colon obstruction after resection with new anastomosis technique implementation and to identify prognostic value of each risk factor on the development of AL. Methods: A retrospective analysis of prospectively acquired data of 155 consecutive emergency patients with cancer of the proximal rectum and sigmoid colon complicated by chronic bowel obstruction in the stage of subcompensation and decompensation were included in our study and divided into two groups. In the basic group (n=95), primary nonfunctional anastomosis (PNA) was performed after resection of the rectum. In the comparing group (n=60), resection of the colon or rectum with primary anastomosis was performed. Results: Postoperative complications have arisen in 5(5,3%) patients of group I and 11 (18,4%) patients of group II. AL was developed only in 1 patient in the basic group (1,1%) and in 7 (11,7%) patients of the compared group on the 5 th -12 th day after the operation. We have worked out the rating score of risk factors of AL.A score was given for each AL factor which we had selected for the elaboration of this scale. Conclusions: Based on AL risk factors scale we highlighted five levels of risk which have significant clinical meaning and help surgeons decide finally how to finish operation in a patient with bowel obstruction to avoid AL. PNA with preventive transversostoma was shown to provide adequate decompression of the colon, reliable prevention of colorectal AL and avoid complex reconstructive operations.KEYWORDS: colorectal cancer, bowel obstruction, anastomotic leakage.