hanan Abdurabu - Academia.edu (original) (raw)

Papers by hanan Abdurabu

Surgery for Obesity and Related Diseases, Mar 1, 2023

Introduction Sleeve gastrectomy (LSG) is one of the most popular bariatric procedures. We present... more Introduction Sleeve gastrectomy (LSG) is one of the most popular bariatric procedures. We present our long-term results regarding weight loss, comorbidities, and gastric reflux disease. Material and Methods We identified patients who underwent LSG in our institution between 2006 and 2009. We revised the data, and the patients with outdated contact details were tracked with the national health insurance database and social media (facebook). Each of the identified patients was asked to complete an online or telephone survey covering, among others, their weight and comorbidities. On that basis, we calculated the percent total weight loss (%TWL) and percent excess weight loss (%EWL), along with changes in body mass index (ΔBMI). Satisfactory weight loss was set at >50% EWL (for BMI = 25 kg/m 2). We evaluated type 2 diabetes (T2DM) and arterial hypertension (AHT) based on the pharmacological therapy. GERD presence was evaluated by the typical symptoms and/or proton pump inhibitor (PPI) therapy. Results One hundred twenty-seven patients underwent LSG between 2006 and 2009. One hundred twenty patients were qualified for this study. Follow-up data was available for 100 participants (47 female, 53 male). Median follow-up period reached 8.0 years (from 7.1 to 10.7). Median BMI upon qualification for LSG was 51.6 kg/m 2. Sixteen percent of patients required revisional surgery over the years (RS group), mainly because of insufficient weight loss (14 Roux-Y gastric bypass-LRYGB; one mini gastric bypass, one gastric banding). For the LSG (LSG group n = 84), the mean %EWL was 51.1% (±22.3), median %TWL was 23.5% (IQR 17.7-33.3%), and median ΔBMI was 12.1 kg/m 2 (IQR 8.2-17.2). Fifty percent (n = 42) of patients achieved the satisfactory %EWL of 50%. For RS group, the mean %EWL was 57.8% (±18.2%) and median %TWL reached 33% (IQR 27.7-37.9%). Sixty-two percent (n = 10) achieved the satisfactory weight loss. Fifty-nine percent of patients reported improvement in AHT therapy, 58% in T2DM. After LSG, 60% (n = 60) of patients reported recurring GERD symptoms and 44% were treated with proton pomp inhibitors (PPI). In 93% of these cases, GERD has developed de novo. Conclusions Isolated LSG provides fairly good effects in a long-term follow-up with mean %EWL at 51.1%. Sixteen percent of patients require additional surgery due to insufficient weight loss. More than half of the subjects observe improvement in AHT and T2DM. Over half of the patients complain of GERD symptoms, which in most of the cases is a de novo complaint.

Surgery for Obesity and Related Diseases, Sep 1, 2022

Background: Day-case surgery (DCS) has boomed over recent years, as has laparoscopic sleeve gastr... more Background: Day-case surgery (DCS) has boomed over recent years, as has laparoscopic sleeve gastrectomy (SG) for the treatment of morbid obesity. The objective of this study was to evaluate the safety and feasibility of day-case SG. Methods: This was a prospective, nonrandomized study of 100 patients undergoing day-case SG from May 2011 to July 2013. All patients met the criteria for DCS and for the treatment of morbid obesity. Standard surgical, anesthetic, and analgesic protocols were used. The primary study endpoint was the unplanned overnight admission rate. Secondary endpoints were standard DCS criteria, frequency and type of complications, and satisfaction rate of performing day-case SG. The shortterm postoperative course of patients undergoing day-case and conventional SG also were compared. Results: A total of 416 patients were screened and 100 (24%) were included. There were 8 unplanned overnight admissions. Seven unexpected consultations, 7 hospital readmissions, and 5 major complications were recorded, including 3 cases of unexpected surgery for gastric leak. At follow-up, 96% of the patients were satisfied with day-case SG. The short-term postoperative course was similar among patients undergoing DCS and conventional management. Conclusion: In selected patients, day-case SG is feasible with acceptable complication and readmission rates. The postoperative course was similar to that observed for standard SG.

American Journal of Gastroenterology

Background Endoscopic gastroplasty (ESG) is safe and effective in patients with a body mass index... more Background Endoscopic gastroplasty (ESG) is safe and effective in patients with a body mass index (BMI) more than 30, with few cases reported in patients with overweight (BMI 27-30) . However, evidence is lacking in the overweight group as the procedure is not currently performed routinely for such patients. In this study, we aim to evaluate the safety and efficacy of ESG in patients with a BMI between 27 and 30 who failed other weight loss modalities and/or had weight-related comorbidities. Methods This was a subgroup analysis of data pertaining to adults with a BMI between 27 and 30 who underwent ESG as a primary weight loss intervention. Data were abstracted from our longitudinal, prospective single-center registry. We analyzed weight loss, comorbidity resolution, adverse events, revisions, and quality of life using Bariatric Analysis and Reporting Outcome System (BAROS) Results Out of 3,797 ESG procedures, 656 patients (17%) had a BMI of 27-30. Mean age was 33 ± 9 years and wome...

Journal of the American College of Surgeons, 2021

BACKGROUND To date, there is insufficient data on long-term outcomes of weight loss surgery in ch... more BACKGROUND To date, there is insufficient data on long-term outcomes of weight loss surgery in children and adolescents with obesity beyond 5 years follow-up. This study aimed to analyze durability of weight loss and comorbidity resolution, growth velocity, and adverse events associated with laparoscopic sleeve gastrectomy (LSG) in children and adolescents with severe obesity. STUDY DESIGN In this prospective cohort study, 2,504 children and adolescents with Class II/III obesity who were enrolled in a multidisciplinary, family-based pediatric obesity management program underwent LSG between 2008 and 2021. Weight loss, growth, comorbidity resolution, and adverse event data during the first 10 years after LSG were analyzed. RESULTS The cohort age was 5 to 21 years at the time of surgery, and 55% were females. Percentage of excess weight lost during short- (1 to 3 years; N=2,051), medium- (4 to 6 years; N=1,268) and long-term (7 to 10 years; N=632) follow-up was 82.3 ± 20.5%, 76.3 ± 29.1%, and 71.1 ± 26.9%, respectively. Complete comorbidity remission at long-term follow-up was observed in 74%, 59%, and 64% of type 2 diabetes, dyslipidemia, and hypertension cases, respectively. Height z-score change at short-, medium-, and long-term follow up was 0.1 ± 0.5, 0.1 ± 1.2, and 0.0 ± 0.8, respectively, representing no significant change in growth velocity. There were 27 adverse events (1%) with no procedure-related mortality. CONCLUSION Long term follow up of laparoscopic sleeve gastrectomy in children and adolescents demonstrates durable weight loss, maintained comorbidity resolution, and unaltered growth.

Medical Education Online, 2014

Gastrointestinal Endoscopy, 2022

BACKGROUND & AIMS Endoscopic bariatric therapies are less invasive alternatives and endoscopi... more BACKGROUND & AIMS Endoscopic bariatric therapies are less invasive alternatives and endoscopic gastroplasty (ESG) represents the latest evolution. This study aims to compare weight loss, safety and comorbidity resolution of ESG compared to laparoscopic sleeve gastrectomy (LSG). METHODS This was a propensity score matched study of patients who underwent LSG or ESG. Primary outcome was weight loss at 6, 12, 24, and 36 months. A non-inferiority margin of 10% total weight loss (%TWL) was used. The secondary outcomes were safety and comorbidity resolution. RESULTS 1:1 propensity score matching yielded 3018 patient pairs. Average age and body mass index (BMI) were 34 ± 10 years and 33± 3 kg/m2, respectively and 89% were female. Mean %excess weight loss (%EWL) at one, two, and three years after ESG was 77.1 ± 24.6%, 75.2 ± 47.9%, and 59.7 ± 57.1% respectively. Mean %EWL at one, two, and three years after LSG was 95.1 ± 20.5%, 93.6 ± 31.3%, and 74.3 ± 35.2%, respectively. %TWL mean difference (95% confidence interval; p-value) was 9.7 (6.9-11.8; p<0.001) %, 6.0 (-2.0-9.4; p<0.001) % and 4.8 (-1.5-8.7; p<0.001) % at one, two, and three years, respectively. Non-inferiority was demonstrated at all follow-up visits. Fourteen ESG patients developed adverse events (0.5%) vs ten LSG patients (0.3%). Co-morbidity remission rates after ESG vs LSG were 64% vs 82% for diabetes, 66% vs 64% for dyslipidemia, and 51% vs 46% for hypertension, respectively. Eighty ESG patients (2.7%) underwent revision to LSG for insufficient weight loss or weight regain, and 28 had re-suturing after primary ESG (0.9%). CONCLUSIONS ESG induces non-inferior weight loss to LSG with similar co-morbidity resolution and safety profiles.

$Research paper thumbnail of Refractory thrombocytopenia in SLE patient with massive thigh hematoma and hematuria successfully treated with Rituximab: Case Report$

International Journal of Clinical Rheumatology, 2019

Background: Systemic Lupus Erythematosus is a multisystemic inflammatory disease with broad clini... more Background: Systemic Lupus Erythematosus is a multisystemic inflammatory disease with broad clinical presentation, 9.5% to 44.5% of patients with SLE have thrombocytopenia complication of different grades. No significant increase in risk of hemorrhage was found in patients with SLE with moderate thrombocytopenia, while those with severe thrombocytopenia frequently developed bleeding, which is associated with the activity of the disease and potentially life-threatening condition, if left untreated. Case presentation: We report a case of 35-year-old SLE male patient, presented with sudden painful large non-traumatic ecchymotic lesion on the right thigh extending to calf with macroscopic hematuria. At presentation, platelets count was 50 x 10 9 /L with hemoglobin dropping from 10.3 to 6.9 g/dl. Anticardiolipin antibody and Antiphospholipid antibody were absent. Other factors including infection and visceral involvement were excluded. MRI of the thigh showed huge intramuscular hematoma extending to calf. Satisfactory control was partially achieved with platelet transfusion, pulse steroid, cellcept, IVIG (intravenous immunoglobulins) and consequently Rituximab. Our case describes refractory thrombocytopenia not responding to multiple agents including high dose steroids, cellcept, platelet transfusion, IVIG (intravenous immunoglobulins) and cyklokapron; however, it achieved its complete remission with Rituximab. Bleeding is not usual presentation with moderate thrombocytopenia in SLE patients and presumably played a role in prognosis. Conclusion: Our case report has demonstrated the efficacy of treating refractory thrombocytopenia resistant to steroids due to Systemic Lupus Erythematosus in whom other reasonable options have been exhausted.