The study analyzed risk factors for anastomotic fistula (complications after surgery) in 306 rectal cancer patients who underwent laparoscopic surgery. The training set included 214 patients, of whom 29 (13.6%) developed an anastomotic fistula after surgery. The researchers identified five main predictive factors: patient gender, tumor stage, tumor location, duration of surgery, and hypoalbuminemia (low level of protein in the blood). The highest risk factor was hypoalbuminemia with an odds ratio of 4.28, followed by tumor stage with an odds ratio of 3.66. The created predictive model achieved an accuracy (AUC) of 0.776, which means a good ability to identify high-risk patients. Validation of the model on an independent set of 92 patients confirmed its reliability. This model provides clinicians with a tool for early identification of high-risk patients and enables preventive measures to reduce complications after surgery.