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Hartmann’s Colectomy and Reversal in Diverticulitis: A Population-Level Assessment

  • Original Contribution
  • Published:
Diseases of the Colon & Rectum

PURPOSE

This study was designed to assess the costs and outcomes of colostomy and colostomy reversal in patients with diverticulitis and examine the impact of such procedures on the health care system.

METHODS

We employed a retrospective design and used a Washington State administrative database to identify patients undergoing operations with colostomy (1987–2002) who were followed over time. Descriptive and comparative analysis was performed, focusing on patients with diverticulitis.

RESULTS

There were 16,556 patients who underwent colostomy and 5,420 (32.7 percent) were for diverticulitis and its related complications (mean age, 64.8 ± 15.1 years; 53.2 percent female). In patients with diverticulitis, the rate of colostomy reversal was 56.3 percent (80 percent in patients less than 50 years, and 30 percent in patients over 77 years). The in-hospital mortality rate after colostomy reversal was 0.36 percent, and was 2.6 percent in those over 77 years of age. After colostomy reversal a second stoma was used in 3.4 percent, reoperation was required for bleeding complications in 0.6 percent, and infectious complications were noted in 2 percent. The length of time from colostomy to its reversal was approximately five months (138.1 ± 164 days; interquartile range, 72–156). The relationship between the length of time from colostomy to reversal was evaluated and the adjusted odds of a second stoma being used at the time of colostomy reversal were 45 percent higher (odds ratio, 1.45; 95 percent confidence interval, 1.22, 1.73) for each increase in time interval (<3, 6–9, 9–12, >12 months).

CONCLUSIONS

One-third of all colostomies were related to diverticulitis and only 56 percent were reversed. We identified a higher than expected mortality rate among older patients undergoing colostomy reversal. The impact of colostomy and reversal operations on both patients and the health care system is significant.

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REFERENCES

  1. KP Nugent P Daniels B Stewart R Patankar CD Johnson (1999) ArticleTitleQuality of life in stoma patients Dis Colon Rectum 42 1569–74 Occurrence Handle1:STN:280:DC%2BD3c%2FnvVKgtA%3D%3D Occurrence Handle10613475

    CAS  PubMed  Google Scholar 

  2. P Marquis A Marrel B Jambon (2003) ArticleTitleQuality of life in patients with stomas: the Montreux Study Ostomy Wound Manage 49 48–55

    Google Scholar 

  3. WD Wong SD Wexner A Lowry et al. (2000) ArticleTitlePractice parameters for the treatment of sigmoid diverticulitis–supporting documentation. The Standards Task Force. The American Society of Colon and Rectal Surgeons Dis Colon Rectum 43 290–7 Occurrence Handle1:STN:280:DC%2BD3c7psFantA%3D%3D Occurrence Handle10733108

    CAS  PubMed  Google Scholar 

  4. L Kohler S Sauerland E Neugebauer (1999) ArticleTitleDiagnosis and treatment of diverticular disease: results of a consensus Surg Endosc 13 430–6 Occurrence Handle1:STN:280:DyaK1M7psVyqtw%3D%3D Occurrence Handle10094765

    CAS  PubMed  Google Scholar 

  5. Mendeloff AI, Everhart JE. Diverticular disease of the colon. In: Everhart JE, ed. Digestive disease in the United States: epidemiology and impact. Washington DC: U.S. Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, 1994:553–65

  6. C Belmonte JV Klas JJ Perez et al. (1996) ArticleTitleThe Hartmann procedure. First choice or last resort in diverticular disease? Arch Surg 131 612–7 Occurrence Handle1:STN:280:BymB2c%2FivFA%3D Occurrence Handle8645067

    CAS  PubMed  Google Scholar 

  7. TB Elliott S Yego TT Irvin (1997) ArticleTitleFive-year audit of the acute complications of diverticular disease Br J Surg 84 535–9 Occurrence Handle1:STN:280:ByiB28jlvVU%3D Occurrence Handle9112911

    CAS  PubMed  Google Scholar 

  8. M Schein G Decker (1988) ArticleTitleThe Hartmann procedure: extended indications in severe intra-abdominal infection Dis Colon Rectum 31 126–9 Occurrence Handle1:STN:280:BieC3M%2FovV0%3D Occurrence Handle3338344

    CAS  PubMed  Google Scholar 

  9. RA Deyo DC Cherkin MA Ciol (1992) ArticleTitleAdapting a clinical comorbidity index for use with ICD-9-CM administrative databases J Clin Epidemiol 45 613–9 Occurrence Handle10.1016/0895-4356(92)90133-8 Occurrence Handle1:STN:280:By2A3c%2FjvFY%3D Occurrence Handle1607900

    Article  CAS  PubMed  Google Scholar 

  10. ME Charlson P Pompei KL Ales CR MacKenzie (1987) ArticleTitleA new method of classifying prognostic comorbidity in longitudinal studies: development and validation J Chronic Dis 40 373–83 Occurrence Handle10.1016/0021-9681(87)90171-8 Occurrence Handle1:STN:280:BiiC28nlsVc%3D Occurrence Handle3558716

    Article  CAS  PubMed  Google Scholar 

  11. MA Singer RL Nelson (2002) ArticleTitlePrimary repair of penetrating colon injuries: a systematic review Dis Colon Rectum 45 1579–87 Occurrence Handle12473879

    PubMed  Google Scholar 

  12. WH Thomson SS Carter (1986) ArticleTitleOn-table lavage to achieve safe restorative rectal and emergency left colonic resection without covering colostomy Br J Surg 73 61–3 Occurrence Handle1:STN:280:BimC3s3jsVY%3D Occurrence Handle3947879

    CAS  PubMed  Google Scholar 

  13. J Stewart RH Diament TG Brennan (1993) ArticleTitleManagement of obstructing lesions of the left colon by resection, on-table Surgery 114 502–5 Occurrence Handle1:STN:280:ByyA2sjhslc%3D Occurrence Handle8367803

    CAS  PubMed  Google Scholar 

  14. L Zorcolo L Covotta N Carlomagno DC Bartolo (2003) ArticleTitleSafety of primary anastomosis in emergency colo-rectal surgery Colorectal Dis 5 262–9 Occurrence Handle1:STN:280:DC%2BD3s3ls1KjtA%3D%3D Occurrence Handle12780890

    CAS  PubMed  Google Scholar 

  15. JJ Park A Del Pino CP Orsay RL Nelson RK Pearl JR Cintron H Abcarian (1999) ArticleTitleStoma complications: the Cook County Hospital experience Dis Colon Rectum 42 1575–80 Occurrence Handle1:STN:280:DC%2BD3c%2FnvVKgtQ%3D%3D Occurrence Handle10613476

    CAS  PubMed  Google Scholar 

  16. JH Saghir FD McKenzie DM Leckie et al. (2001) ArticleTitleFactors that predict complications after construction of a stoma: a retrospective study Eur J Surg 167 531–4 Occurrence Handle1:STN:280:DC%2BD3Mrht1Cksw%3D%3D Occurrence Handle11560389

    CAS  PubMed  Google Scholar 

  17. A Del Pino JR Cintron CP Orsay RK Pearl A Tan H Abcarian (1997) ArticleTitleEnterostomal complications: are emergently created enterostomas at greater risk? Am Surg 63 653–6 Occurrence Handle1:STN:280:ByiA2cnht1Y%3D Occurrence Handle9202542

    CAS  PubMed  Google Scholar 

  18. K Mealy E O’Broin J Donohue A Tanner FB Keane (1996) ArticleTitleReversible colostomy–what is the outcome? Dis Colon Rectum 39 1227–31 Occurrence Handle1:STN:280:ByiD2snhtFY%3D Occurrence Handle8918429

    CAS  PubMed  Google Scholar 

  19. JA Porter EP Salvati RJ Rubin TE Eisenstat (1989) ArticleTitleComplications of colostomies Dis Colon Rectum 32 299–303 Occurrence Handle1:STN:280:BiaC2s%2FgsFE%3D Occurrence Handle2924670

    CAS  PubMed  Google Scholar 

  20. PW Carne GM Robertson FA Frizelle (2003) ArticleTitleParastomal hernia Br J Surg 90 784–93 Occurrence Handle1:STN:280:DC%2BD3szitlGrsg%3D%3D Occurrence Handle12854101

    CAS  PubMed  Google Scholar 

  21. SB Labow EP Salvati RJ Rubin (1973) ArticleTitleThe Hartman procedure in the treatment of diverticular disease Dis Colon Rectum 16 392–4 Occurrence Handle1:STN:280:CSuD3czpvVE%3D Occurrence Handle4741987

    CAS  PubMed  Google Scholar 

  22. H Laimon (1974) ArticleTitleHartmann resection for acute diverticulitis Rev Surg 31 1–6 Occurrence Handle1:STN:280:CSuD1MfitlY%3D Occurrence Handle4812882

    CAS  PubMed  Google Scholar 

  23. K Eng JH Ranson SA Localio (1977) ArticleTitleResection of the perforated segment. A significant advance in treatment of diverticulitis with free perforation or abscess Am J Surg 133 67–72 Occurrence Handle1:STN:280:CSiC3cblsVw%3D Occurrence Handle835782

    CAS  PubMed  Google Scholar 

  24. GC Nunes AH Robnett RM Kremer RE Ahlquist SuffixJr (1979) ArticleTitleThe Hartmann procedure for complications of diverticulitis Arch Surg 114 425–9 Occurrence Handle1:STN:280:CSaC28rhtVQ%3D Occurrence Handle435055

    CAS  PubMed  Google Scholar 

  25. CW Liebert SuffixJr BM DeWeese (1981) ArticleTitlePrimary resection without anastomosis for perforation of acute diverticulitis Surg Gynecol Obstet 152 30–2 Occurrence Handle7455886

    PubMed  Google Scholar 

  26. FC Bakker HF Hoitsma Den G Otter (1982) ArticleTitleThe Hartmann procedure Br J Surg 69 580–2 Occurrence Handle1:STN:280:BiyD38zpt10%3D Occurrence Handle7127036

    CAS  PubMed  Google Scholar 

  27. EJ Lubbers HH de Boer (1982) ArticleTitleInherent complications of Hartmann’s operation Surg Gynecol Obstet 155 717–21 Occurrence Handle1:STN:280:BiyD2c7nt1Y%3D Occurrence Handle7135180

    CAS  PubMed  Google Scholar 

  28. TE Eisenstat RJ Rubin EP Salvati (1983) ArticleTitleSurgical management of diverticulitis: the role of the Hartmann procedure Dis Colon Rectum 26 429–32 Occurrence Handle1:STN:280:BiyB3szpsVA%3D Occurrence Handle6861572

    CAS  PubMed  Google Scholar 

  29. GA Bell ON Panton (1984) ArticleTitleHartmann resection for perforated sigmoid diverticulitis: a retrospective study of the Vancouver General Hospital experience Dis Colon Rectum 27 253–6 Occurrence Handle1:STN:280:BiuC1c7pvVU%3D Occurrence Handle6714033

    CAS  PubMed  Google Scholar 

  30. L Ling T Aberg (1984) ArticleTitleHartmann procedure Acta Chir Scand 150 413–7 Occurrence Handle1:STN:280:BiqD3MbhtlM%3D Occurrence Handle6435365

    CAS  PubMed  Google Scholar 

  31. JW Underwood CG Marks (1984) ArticleTitleThe septic complications of sigmoid diverticular disease Br J Surg 71 209–11 Occurrence Handle1:STN:280:BiuC38bitlw%3D Occurrence Handle6697123

    CAS  PubMed  Google Scholar 

  32. L Auguste E Borrero L Wise (1985) ArticleTitleSurgical management of perforated colonic diverticulitis Arch Surg 120 450–2 Occurrence Handle1:STN:280:BiqC2szotlE%3D Occurrence Handle3985790

    CAS  PubMed  Google Scholar 

  33. AW Hackford DJ Schoetz SuffixJr JA Coller MC Veidenheimer (1985) ArticleTitleSurgical management of complicated diverticulitis: the Lahey Clinic experience, 1967 to 1982 Dis Colon Rectum 28 317–21 Occurrence Handle1:STN:280:BiqB3czivFQ%3D Occurrence Handle3996147

    CAS  PubMed  Google Scholar 

  34. OA Hulkko ST Laitinen KA Haukipuro MJ Stahlberg TS Juvonen MI Kairaluoma (1986) ArticleTitleThe Hartmann procedure for the treatment of colorectal emergencies Acta Chir Scand 152 531–5 Occurrence Handle1:STN:280:BiiD2s3jtVM%3D Occurrence Handle3788398

    CAS  PubMed  Google Scholar 

  35. ET Mallonga WH Brummelkamp TM Van Gulik CW Taat (1986) ArticleTitleThe Hartmann procedure: its role in acute complicated diverticulitis Neth J Surg 38 171–4 Occurrence Handle1:STN:280:BiiC3Mnkt10%3D Occurrence Handle3808372

    CAS  PubMed  Google Scholar 

  36. AA Shephard MR Keighley (1986) ArticleTitleAudit on complicated diverticular disease Ann R Coll Surg Engl 68 8–10 Occurrence Handle1:STN:280:BimC38bgt10%3D Occurrence Handle3947025

    CAS  PubMed  Google Scholar 

  37. RO Gregg (1987) ArticleTitleAn ideal operation for diverticulitis of the colon Am J Surg 153 285–90 Occurrence Handle1:STN:280:BiiC2Mvhtlw%3D Occurrence Handle3826510

    CAS  PubMed  Google Scholar 

  38. JL Sweeney DC Hoffmann (1987) ArticleTitleRestoration of continuity after Hartmann’s procedure for the complications of diverticular disease ANZ J Surg 57 823–5 Occurrence Handle1:STN:280:BieC2cbkt1M%3D

    CAS  Google Scholar 

  39. PA Haas GP Haas (1988) ArticleTitleA critical evaluation of the Hartmann’s procedure Am Surg 54 380–5 Occurrence Handle1:STN:280:BieB3sbitlU%3D Occurrence Handle3377332

    CAS  PubMed  Google Scholar 

  40. GJ Kourtesis RA Williams SE Wilson (1988) ArticleTitleSurgical options in acute diverticulitis: value of sigmoid resection in dealing with the septic focus ANZ J Surg 58 955–9 Occurrence Handle1:STN:280:BiaD2sngt1c%3D

    CAS  Google Scholar 

  41. M Hold H Denck P Bull (1990) ArticleTitleSurgical management of perforating diverticular disease in Austria Int J Colorectal Dis 5 195–9 Occurrence Handle1:STN:280:By6C2c%2Fht1M%3D Occurrence Handle2286801

    CAS  PubMed  Google Scholar 

  42. JG Geoghegan IL Rosenberg (1991) ArticleTitleExperience with early anastomosis after the Hartmann procedure Ann R Coll Surg Engl 73 80–2 Occurrence Handle1:STN:280:By6B3cnos1A%3D Occurrence Handle2018324

    CAS  PubMed  Google Scholar 

  43. E Totte U Creve A Hubens (1993) ArticleTitleThe Hartmann procedure revisited Acta Chir Belg 93 159–63 Occurrence Handle1:STN:280:ByuD2MrlsVU%3D Occurrence Handle8237229

    CAS  PubMed  Google Scholar 

  44. AL Khan AK Ah-See TJ Crofts SD Heys O Eremin (1994) ArticleTitleReversal of Hartmann’s colostomy J R Coll Surg Edinb 39 239–42 Occurrence Handle1:STN:280:ByqC3cnhvFE%3D Occurrence Handle7807457

    CAS  PubMed  Google Scholar 

  45. J Wedell G Banzhaf R Chaoui R Fischer J Reichmann (1997) ArticleTitleSurgical management of complicated colonic diverticulitis Br J Surg 84 380–3 Occurrence Handle1:STN:280:ByiB3s3htlA%3D Occurrence Handle9117315

    CAS  PubMed  Google Scholar 

  46. DC Desai EJ Brennan SuffixJr JF Reilly RD Smink SuffixJr (1998) ArticleTitleThe utility of the Hartmann procedure Am J Surg 175 152–4 Occurrence Handle1:STN:280:DyaK1c7nsFamtw%3D%3D Occurrence Handle9515534

    CAS  PubMed  Google Scholar 

  47. G Zeitoun A Laurent F Rouffet et al. (2000) ArticleTitleResearch TF. Multicentre, randomized clinical trial of primary versus secondary sigmoid resection in generalized peritonitis complicating sigmoid diverticulitis Br J Surg 87 1366–74 Occurrence Handle10.1046/j.1365-2168.2000.01552.x Occurrence Handle1:STN:280:DC%2BD3crgtVGksw%3D%3D Occurrence Handle11044163

    Article  CAS  PubMed  Google Scholar 

  48. AW Gooszen HG Gooszen W Veerman et al. (2001) ArticleTitleOperative treatment of acute complications of diverticular disease: primary or secondary anastomosis after sigmoid resection Eur J Surg 167 35–9 Occurrence Handle1:STN:280:DC%2BD3MzitFOnsQ%3D%3D Occurrence Handle11213818

    CAS  PubMed  Google Scholar 

  49. MK Schilling CA Maurer O Kollmar MW Buchler (2001) ArticleTitlePrimary vs. secondary anastomosis after sigmoid colon resection for perforated diverticulitis (Hinchey Stage III and IV): a prospective outcome and cost analysis Dis Colon Rectum 44 699–705 Occurrence Handle1:STN:280:DC%2BD3M3msVehtw%3D%3D Occurrence Handle11357032

    CAS  PubMed  Google Scholar 

  50. N Regenet P Pessaux S Hennekinne et al. (2003) ArticleTitlePrimary anastomosis after intraoperative colonic lavage vs. Hartmann’s procedure in generalized peritonitis complicating diverticular disease of the colon Int J Colorectal Dis 18 503–7 Occurrence Handle1:STN:280:DC%2BD3svlsFKjuw%3D%3D Occurrence Handle12910361

    CAS  PubMed  Google Scholar 

  51. SJ Wigmore GS Duthie IE Young EM Spalding JB Rainey (1995) ArticleTitleRestoration of intestinal continuity following Hartmann’s procedure: the Lothian experience 1987-1992 Br J Surg 82 27–30 Occurrence Handle1:STN:280:ByqC1cjnsFQ%3D Occurrence Handle7881946

    CAS  PubMed  Google Scholar 

  52. NW Pearce SD Scott SJ Karran (1992) ArticleTitleTiming and method of reversal of Hartmann’s procedure Br J Surg 79 839–41 Occurrence Handle1:STN:280:ByyD3cnpvFU%3D Occurrence Handle1393489

    CAS  PubMed  Google Scholar 

  53. AM Roe S Prabhu A Ali C Brown AJ Brodribb (1991) ArticleTitleReversal of Hartmann’s procedure: timing and operative technique Br J Surg 78 1167–70 Occurrence Handle1:STN:280:By2D28bltlc%3D Occurrence Handle1958975

    CAS  PubMed  Google Scholar 

  54. K Khosraviani WJ Campbell TG Parks ST Irwin (2000) ArticleTitleHartmann procedure revisited Eur J Surg 166 878–81 Occurrence Handle1:STN:280:DC%2BD3MzgtlKhsQ%3D%3D Occurrence Handle11097155

    CAS  PubMed  Google Scholar 

  55. SG Ghorra TP Rzeczycki R Natarajan VE Pricolo (1999) ArticleTitleColostomy closure: impact of preoperative risk factors on morbidity Am Surg 65 266–9 Occurrence Handle1:STN:280:DyaK1M7ntlKhuw%3D%3D Occurrence Handle10075307

    CAS  PubMed  Google Scholar 

  56. DM Mosdell RC Doberneck (1991) ArticleTitleMorbidity and mortality of ostomy closure Am J Surg 162 633–7 Occurrence Handle1:STN:280:ByuB2s%2FksVE%3D Occurrence Handle1670240

    CAS  PubMed  Google Scholar 

  57. JO Keck BT Collopy PJ Ryan R Fink JR Mackay RJ Woods (1994) ArticleTitleReversal of Hartmann’s procedure: effect of timing and technique on ease and safety Dis Colon Rectum 37 243–8 Occurrence Handle1:STN:280:ByuC1crkslc%3D Occurrence Handle8137671

    CAS  PubMed  Google Scholar 

  58. N Regenet JJ Tuech P Pessaux et al. (2002) ArticleTitleIntraoperative colonic lavage with primary anastomosis vs. Hartmann’s procedure for perforated diverticular disease of the colon: a consecutive study Hepatogastroenterology 49 664–7 Occurrence Handle1:STN:280:DC%2BD38zitFGgsA%3D%3D Occurrence Handle12063965

    CAS  PubMed  Google Scholar 

  59. S Landen P Nafteux (2002) ArticleTitlePrimary anastomosis and diverting colostomy in diffuse diverticular peritonitis Acta Chir Belg 102 24–9 Occurrence Handle1:STN:280:DC%2BD387ptlKjug%3D%3D Occurrence Handle11925735

    CAS  PubMed  Google Scholar 

  60. JJ Murray DJ Schoetz SuffixJr JA Coller PL Roberts MC Veidenheimer (1991) ArticleTitleIntraoperative colonic lavage and primary anastomosis in nonelective colon resection Dis Colon Rectum 34 527–31 Occurrence Handle1:STN:280:By6B2srmslA%3D Occurrence Handle2055137

    CAS  PubMed  Google Scholar 

  61. RT Poon WL Law KW Chu J Wong (1998) ArticleTitleEmergency resection and primary anastomosis for left-sided obstructing colorectal carcinoma in the elderly Br J Surg 85 1539–42 Occurrence Handle1:STN:280:DyaK1M%2FjvFGhtA%3D%3D Occurrence Handle9823920

    CAS  PubMed  Google Scholar 

  62. S Biondo D Pares J Marti Rague et al. (2002) ArticleTitleEmergency operations for nondiverticular perforation of the left colon Am J Surg 183 256–60 Occurrence Handle11943122

    PubMed  Google Scholar 

  63. GJ Maddern Y Nejjari A Dennison F Siriser E Bardoxaglou B Launois (1995) ArticleTitlePrimary anastomosis with transverse colostomy as an alternative to Hartmann’s procedure Br J Surg 82 170–1 Occurrence Handle1:STN:280:ByqB28fnsFE%3D Occurrence Handle7749677

    CAS  PubMed  Google Scholar 

  64. Nelson R, Singer M. Primary repair for penetrating colon injuries. Cochrane Database Syst Rev 2003:CD002247

  65. A Chiappa A Zbar F Biella C Staudacher (2000) ArticleTitleOne-stage resection and primary anastomosis following acute obstruction of the left colon for cancer Am Surg 66 619–22 Occurrence Handle1:STN:280:DC%2BD3czptVCjtA%3D%3D Occurrence Handle10917469

    CAS  PubMed  Google Scholar 

  66. B Forloni R Reduzzi A Paludetti L Colpani G Cavallari D Frosali (1998) ArticleTitleIntraoperative colonic lavage in emergency surgical treatment of left-sided colonic obstruction Dis Colon Rectum 41 23–7 Occurrence Handle1:STN:280:DyaK1c7mvFWhtA%3D%3D Occurrence Handle9510306

    CAS  PubMed  Google Scholar 

  67. TG Allen-Mersh (1993) ArticleTitleShould primary anastomosis and on-table colonic lavage be standard treatment for left colon emergencies? Ann R Coll Surg Engl 75 195–8 Occurrence Handle1:STN:280:ByyA3M7pt1M%3D Occurrence Handle8323217

    CAS  PubMed  Google Scholar 

  68. S Biondo (2001) ArticleTitleRole of resection and primary anastomosis of the left colon in the presence of peritonitis (Br J Surg 2000; 87: 1580-4) Br J Surg 88 1419 Occurrence Handle1:STN:280:DC%2BD3Mrjt1Sltg%3D%3D Occurrence Handle11578308

    CAS  PubMed  Google Scholar 

  69. M Hoemke J Treckmann R Schmitz S Shah (1999) ArticleTitleComplicated diverticulitis of the sigmoid: a prospective study concerning primary resection with secure primary anastomosis Dig Surg 16 420–4 Occurrence Handle1:STN:280:DC%2BD3c%2Fjs12qsQ%3D%3D Occurrence Handle10567805

    CAS  PubMed  Google Scholar 

  70. AW Gooszen RA Tollenaar RH Geelkerken et al. (2001) ArticleTitleProspective study of primary anastomosis following sigmoid resection for suspected acute complicated diverticular disease Br J Surg 88 693–7 Occurrence Handle1:STN:280:DC%2BD3M3lt1ejsg%3D%3D Occurrence Handle11350443

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, University of Washington, Seattle, Washington

    Leon Salem M.D., Daniel A. Anaya M.D., Kurt E. Roberts M.D. & David R. Flum M.D., M.P.H.

  2. Department of Health Services, University of Washington, Seattle, Washington

    David R. Flum M.D., M.P.H.

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  1. Leon Salem M.D.
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  3. Kurt E. Roberts M.D.
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Correspondence to David R. Flum M.D., M.P.H..

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Salem, L., Anaya, D., Roberts, K. et al. Hartmann’s Colectomy and Reversal in Diverticulitis: A Population-Level Assessment. Dis Colon Rectum 48, 988–995 (2005). https://doi.org/10.1007/s10350-004-0871-x

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