Publications by authors named "John Lahoud"

6 Publications

  • Page 1 of 1

Perilesional Biopsies Increase Detection of Significant Prostate Cancer in Men with PI-RADS 4/5 Lesions: Validation of the PI-RADS Steering Committee Recommendation.

Eur Urol 2021 Aug 13;80(2):260-261. Epub 2021 Feb 13.

Department of Urology, Westmead Hospital, Westmead, Australia; Discipline of Surgery, Sydney Medical School, University of Sydney, Sydney, Australia. Electronic address:

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http://dx.doi.org/10.1016/j.eururo.2021.01.039DOI Listing
August 2021

Identifying prostate cancer in men with non-suspicious multi-parametric magnetic resonance imaging of the prostate.

ANZ J Surg 2021 04 21;91(4):578-583. Epub 2021 Jan 21.

Department of Urology, Westmead Hospital, Westmead, New South Wales, Australia.

Background: To formulate clinical pathways for identifying clinically significant prostate cancer (csPC) and avoiding insignificant prostate cancer (isPC) in those without suspicious regions of interest on multi-parametric magnetic resonance imaging (mpMRI) of the prostate.

Methods: A retrospective review identified patients with negative mpMRI who underwent subsequent transperineal prostate biopsy across two centres. Patient characteristics and association with biopsy results were evaluated using univariate and multivariate regression analyses.

Results: A total of 144 patients were identified as having negative mpMRI and undergoing subsequent transperineal prostate biopsy; 18% (25/144) of the cohort were found to have csPC. Logistic regression analysis failed to identify statistically significant predictive factors. In this cohort, if all patients with prostate-specific antigen > 3.0 were biopsied the least amount of csPC is missed, at 20% (5/25) however all isPC would be diagnosed. The least amount of isPC is diagnosed with a biopsy threshold of >15% from the European Randomized Study of Screening for Prostate Cancer calculator with 20% (5/25) of isPC diagnoses made however only 10.5% (2/19) csPC would be diagnosed. A biopsy threshold of >5% risk reduces the number of csPC missed to 37% (7/19) however increases isPC diagnoses to 54% (13/24) of the population.

Conclusion: False-negative rates of prostate MRI for csPC are significant within our cohort at 18%. The decision to biopsy should be made in conjunction with a risk profile acceptable by the patient and clinician. The current study demonstrates that there is a need to balance the risk of missing csPC and harm of diagnosing isPC.
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http://dx.doi.org/10.1111/ans.16583DOI Listing
April 2021

Transperineal systematic biopsies in addition to targeted biopsies are important in the detection of clinically significant prostate cancer.

ANZ J Surg 2021 04 5;91(4):584-589. Epub 2021 Jan 5.

Department of Urology, Westmead Hospital, Sydney, New South Wales, Australia.

Background: This study aimed to determine whether the addition of transperineal systematic biopsies (SB) to targeted biopsies (TB) improved clinically significant prostate cancer (csPC) detection rates without high increase in insignificant prostate cancer detection rates in an Australian population.

Methods: In this retrospective review, a total of 254 patients who had a Prostate Imaging-Reporting and Data System score between 3 and 5, and a transperineal TB and SB between 2014 and 2019 from two centres were included in this study. The primary outcome of this study was to determine csPC rates on TB and SB. The secondary outcome was a comparison of the Gleason Grade Group between TB and SB. csPC was defined as an International Society of Urological Pathology Gleason Grade Group of 2 or greater.

Results: SB alone detected more csPC overall compared to TB (152/254 (60%) versus 128/254 (51%), respectively). An additional 40 of 254 (16%) csPC cases were diagnosed with the addition of SB. Furthermore, the cost of diagnosing insignificant prostate cancer by SB when TB were negative was an additional 13/254 (5.1%).

Conclusion: A combination of TB and SB provides the best outcomes for detecting csPC and is especially warranted for patients with a higher Prostate Imaging-Reporting and Data System score on multiparametric magnetic resonance imaging.
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http://dx.doi.org/10.1111/ans.16524DOI Listing
April 2021

Evaluating a low-fidelity inguinal canal model.

Surg Radiol Anat 2020 Nov 25;42(11):1323-1328. Epub 2020 Aug 25.

Department of Anatomy, The University of Notre Dame Australia, 160 Oxford Street, Darlinghurst, Sydney, NSW, 2010, Australia.

Purpose: The inguinal canal anatomy is of paramount clinical significance due to the common occurrence of direct and indirect inguinal hernias. However, the inguinal canal is often an area of great difficulty for medical students to understand. The aim of this study was to evaluate the use of a low-cost, low-fidelity inguinal canal model as a teaching and learning aid.

Methods: A low-fidelity inguinal canal model was introduced as a learning aid in an anatomy tutorial on the inguinal region. Students were randomised into intervention (n = 66) and control (n = 40) groups. Following the tutorial, all students completed a multiple-choice question quiz on the inguinal canal. The intervention group also completed a questionnaire evaluating the positive and negative aspects of the model.

Results: Students taught with the inguinal canal model achieved higher scores (mean: 88.31% vs 81.7%, p = 0.087). Positive aspects of the model as described by the students included its simplicity and ability to improve their three-dimensional understanding of the inguinal canal. Students requested more hands-on time with the model during the tutorial.

Conclusion: The present study supports current literature in that low-fidelity anatomy models are a useful adjunct to aid students' learning of complex anatomical concepts. Students may benefit from creating their own inguinal canal model to retain as a personal study tool.
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http://dx.doi.org/10.1007/s00276-020-02553-0DOI Listing
November 2020

Team-based anatomy learning for medical students: preparing tomorrow's surgeons.

ANZ J Surg 2019 06;89(6):628-629

School of Medicine, Department of Anatomy, University of Notre Dame Australia, Sydney, New South Wales, Australia.

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http://dx.doi.org/10.1111/ans.15156DOI Listing
June 2019

Survey of nutritional practices in total gastrectomy and oesophagectomy procedures.

Nutr Diet 2019 04 15;76(2):135-140. Epub 2018 Jul 15.

Department of Nutrition and Dietetics, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.

Aim: Total gastrectomy and Ivor Lewis oesophagectomy procedures are the mainstay of upper gastrointestinal cancer management. Maintenance of adequate nutritional intake is essential for positive patient outcomes. Although numerous nutritional support options exist, clear evidence-based guidelines on the optimal means and duration of nutritional support are lacking. The aim of this study is to establish preliminary data on the current perioperative nutritional practices of upper gastrointestinal surgeons performing these procedures across Australia and New Zealand. It is hoped this will help provide the platform for future research towards establishing evidence-based guidelines in upper gastrointestinal surgery.

Methods: A questionnaire exploring the nutritional practices and considerations of surgeons was developed and emailed to the members of the Australia & New Zealand Gastric & Oesophageal Surgery Association.

Results: A total of 27.4% of Australia & New Zealand Gastric & Oesophageal Surgery Association members completed the questionnaire. Surgeons reported inserting a jejunostomy feeding tube intraoperatively in Ivor Lewis oesophagectomy procedures 80-100% of the time, compared to only 20-39% of the time in total gastrectomy procedures. For both procedures, surgeons often refer their patients to a dietitian preoperatively, and always postoperatively. Preoperative immune-enhancing nutrition is rarely administered. Patient age and BMI are deemed to be of low importance when determining the means of nutritional support.

Conclusions: This study has demonstrated the current nutritional practices employed in Australia and New Zealand for patients undergoing major upper gastrointestinal surgery. Questions remain regarding the noted differences between procedures as well as the optimal means and duration of perioperative nutritional support.
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http://dx.doi.org/10.1111/1747-0080.12447DOI Listing
April 2019
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