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Invited Commentary
November 21, 2018

Decision Making in Colostomy Closure: Acceptable vs Optimal Safety and Selection vs Bias

Author Affiliations
  • 1Department of Surgery, University of North Dakota School of Medicine and the Health Sciences, Grand Forks
JAMA Surg. 2019;154(3):224. doi:10.1001/jamasurg.2018.4366

In this issue of JAMA Surgery, Resio and colleagues1 retrospectively reviewed 1660 patients’ colostomy closures after the Hartmann procedure for diverticulitis in 3 state databases and report that outcomes of closure at 45 to 110 days were no worse than those of later closure. Indeed, patients undergoing closure at 45 to 110 days were readmitted less frequently than patients undergoing closure after 170 days. Smaller subgroups undergoing closure before 90 or before 60 days displayed similar outcomes. The investigators concluded that reversal as early as 45 to 110 days is safe in selected patients.

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