Nasser Alsanea

King Faisal Specialist Hospital Jeddah, Djidda, Makkah, Saudi Arabia

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Publications (9)8.8 Total impact

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    ABSTRACT: Background and objectives: The national data on colorectal cancer in Saudi Arabia has not been analyzed. The objective of this study is to describe the demographics, incidence and survival rates for colorectal cancer in Saudi Arabia for the period 1994-2010. Design: Retrospective analysis of the Saudi Cancer Registry data for the period 1994-2010. Setting: Data from the Saudi Cancer Registry was analyzed by stage at presentation (local, regional, distal, unknown) and survival rates were calculated using the Kaplan-Meier method. Patients: From 9889 colorectal cancer cases, a sample of 549 (5.6%) patients was selected and their living status ascertained to assess survival. Results: Colorectal cancer has been the most common cancer among men and the third commonest among women since 2002 in Saudi Arabia. There has been a slight predominance among men with an average ratio of 116:100 over the years (range: 99:100-132:100). The overall age-standardized rate (ASR) approached a plateau of 9.6/100000 in 2010. The incidence of the disease has been highest in the capital, Riyadh, where it reached 14.5/100000 in 2010. Median age at presentation has been stable at around 60 years (95% confidence Interval (CI): 57-61 years) for men and 55 years (95% CI: 53-58 years) for women. Distant metastasis was diagnosed in 28.4% of patients at the time of presentation and rectal cancer represented 41% of all colorectal cancers diagnosed in 2010. The overall 5-year survival was 44.6% for the period 1994-2004. The ASR for all age groups below 45 years of age was lower than that for the United States. Limitations: The study was retrospective with a possibility of bias from inaccurate staging of patients, and inaccurate survival information and patient demographics due to the underdeveloped census system prior to 2001. Survival data for the period 2005-2010 are lacking. Conclusion: Colorectal cancer presents at a younger age in Saudis, especially in women. This has a major implication for decisions about the threshold age for screening. The ASR has increased, but is still much lower than in developed countries. The lower overall 5-year survival compared with developed countries is due to lack of screening, a higher proportion of advanced stage cancer at presentation, lack of specialized care outside the major cities and a higher proportion of rectal cancer cases.
    Annals of Saudi medicine 09/2015; 35(3):196-202. DOI:10.5144/0256-4947.2015.196 · 0.49 Impact Factor
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    ABSTRACT: Background: Colorectal cancer is the most common cancer among Saudi men and the third commonest among Saudi women. Given the predominance of colorectal cancer compared with other cancers in Saudi Arabia, context-specific guidelines are needed for screening. Methods: Experts from the Saudi Society of Colon and Rectal Surgery, Saudi Gastroenterology Association, Saudi Oncology Society, Saudi Chapter of Enterostomal Therapy, Family Medicine and Department of Public Health at the Saudi Arabian Ministry of Health and a patient advocate was assembled by the Saudi Centre for Evidence-Based Healthcare, a subsidiary of the Saudi Arabian Ministry of Health. The panel collaborated with a methodological team from McMaster University, Canada to develop national guidelines for colorectal cancer screening. After identifying key questions, the panel conducted a systematic review of all reports on the utility of screening, the cost of screening for colorectal cancer in Saudi Arabia and on the values and preferences of Saudi patients. Meta- analyses, when appropriate, were performed to generate pooled estimates of effect. Using the GRADE approach, the panel used the evidence-to-decision (EtD) framework to assess all domains important in determining the strength and direction of the recommendations (benefits and harms, values and preferences, resource implications, equity, acceptability, and feasibility). Judgments related to the EtD domains were resolved through consensus or voting, if consensus was not reached. The final recommendations were developed during a two-day meeting held in Riyadh, Saudi Arabia in March 2015. Conflicts of interests among the panel members were handled according to the World Health Organization rules. Limitations: There is lack of national data on the incidence of adenomatous polyps or the age groups in which the incidence surges. There were no national clinical trials assessing the effectiveness of the different modalities of screening for colorectal cancer and their impact on mortality. Conclusion: The panel recommends screening for colorectal cancer in Saudi Arabia in asymptomatic Saudi patients at average risk of colorectal cancer. An infrastructure should be built to achieve that goal.
    Annals of Saudi medicine 09/2015; 35(3):189-195. DOI:10.5144/0256-4947.2015.189 · 0.49 Impact Factor
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    ABSTRACT: Reported surgical site infection rates range from 2.1% to 40% after colorectal surgery and are believed to be underestimated depending on the method of surveillance. The study aims were to identify an accurate incidence and associated risk factors for abdominal incision surgical site infection after elective open colorectal surgery in a Saudi population. This was a prospective observational longitudinal study of 300 consecutive adult patients, recruited upon admission to an 800-bed tertiary referral center. All consenting adults admitted for elective open colorectal surgery were included. Patients were followed for 36 d post-surgery by two certified and experienced wound care experts who diagnosed abdominal incision surgical site infections. The definition provided by the U.S. Centers for Disease Control and Prevention was used. Statistical analysis was performed using both univariate and multivariable logistic regression. Data were analyzed for 296 patients; the incidence of abdominal surgical site infection was 30%. Factors associated with surgical site infection by univariate analysis were pre-operative pre-albumin (p=0.04, odds ratio [OR] 0.81, 95% confidence interval [CI] 0.66-0.99); operative difficulty because of truncal obesity (p=0.006, OR 2.19, 95% CI 1.25-3.84) and obesity measured by body mass index (p=0.002, OR 4.00, 95% CI 1.95-8.20). Multivariable analysis identified only two significant risk factors: Pre-operative pre-albumin (p=0.02, OR 0.76, 95% CI 0.60-0.96), and obesity measured by body mass index (BMI; p=0.001, OR 4.71, 95% CI 2.20-10.10). Obesity and nutritional status correlated with post-operative abdominal surgical site infection. The method of surveillance and length of follow-up impact the rate reported.
    Surgical Infections 04/2015; 16(3). DOI:10.1089/sur.2013.208 · 1.45 Impact Factor
  • Nasser A N Alsanea ·

    Saudi Journal of Gastroenterology 03/2015; 21(2):59. DOI:10.4103/1319-3767.153806 · 1.12 Impact Factor
  • Nasser Alsanea ·

    Saudi Journal of Gastroenterology 05/2014; 20(3):141-2. DOI:10.4103/1319-3767.132976 · 1.12 Impact Factor
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    ABSTRACT: Background and objectives: Medical and scientific publishing in Saudi Arabia has flourished in the last ten years. Such a form of publishing faces its own obstacles and the experience of the Annals of Saudi Medicine if analyzed can delineate such obstacles. The aim of this study is to identify the workflow obstacles facing the Annals of Saudi Medicine. Methods: Root-cause analysis of the workflow process and output from submission till publication for the period January 2012-December 2013. Key performance indicators were developed and analyzed after being extracted from the online submission system. Results: For the period of the study, 1058 manuscripts were received annually. These manuscripts originated in descending order from: Saudi Arabia 34%, Turkey 16%, India 12%, China 8% and Western Countries 3%. Categories of the submissions were: original articles 53%, case reports 31% and others 16%. Only 103 of the submissions were accepted annually for publication. Out of 7,709 requests to review a manuscript, only 1,579 (20%) resulted in a review. Out of a sample of 744 rated reviews, only 10% were poor in quality. The average turnaround time for review was 79 days. The main reason for the delay was the low response of the reviewers. Conclusion: The Annals of Saudi Medicine is a regional or continental journal with substantial submissions as case reports. This affected its Impact Factor and Hirsch Index. Moreover, the review process is delayed due to the poor response of the reviewers.
    Annals of Saudi medicine 05/2014; 34(3):202-6. DOI:10.5144/0256-4947.2014.202 · 0.49 Impact Factor
  • Nasser Alsanea ·

    Saudi Journal of Gastroenterology 05/2013; 19(3):99-100. DOI:10.4103/1319-3767.111948 · 1.12 Impact Factor
  • Nasser Alsanea ·
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    ABSTRACT: Five major technological changes will herald a new era in health care delivery around the World: digitalization of the personal health record, sharing of health care digital data across different platforms, applications and institutions, delivery of patient services via the internet, use of the digital media and social networking as a medium for education and preventive medicine and introduction of smart applications as counselors to prevent medical errors. The implications of such changes are huge. Saudi Arabia is not isolated from such important developments. This article explores the future of health care delivery with a special focus on the experience of a tertiary care center in Saudi Arabia that has led the wave in such changes regionally.
    Annals of Saudi medicine 03/2012; 32(2):117-20. DOI:10.5144/0256-4947.2012.117 · 0.49 Impact Factor
  • N Alsanea · S Alabbad ·
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    ABSTRACT: A dehisced colorectal anastomosis complicated by a sinus, especially after preoperative radiation for colorectal cancer, may not heal. We describe our experience in the management of such a condition using the endoscopic surgical stapler. Patients who underwent low anterior resection for rectal cancer after preoperative chemoradiation and who developed a dehisced anastomosis complicated by a chronic posterior sinus underwent the procedure. After exclusion of cancer recurrence, the common wall between the sinus and the rectal lumen was stapled using the endoscopic surgical stapler. Four patients received the day-surgery treatment. Healing of the sinus was confirmed in all patients using a contrast enema. Median time to healing was 10 weeks. All patients had a diverting ileostomy which was eventually closed. No complications were noted. Stapling the common wall between the sinus and the rectal lumen after a dehisced anastomosis is a viable option in the treatment of chronic posterior sinuses when coupled with fecal diversion.
    Techniques in Coloproctology 09/2010; 14(3):249-51. DOI:10.1007/s10151-010-0600-5 · 2.04 Impact Factor