Publications by authors named "Leyn P"

An inflammatory myofibroblastic tumor (IMT) is a rare mesenchymal tumor that occurs predominantly in children and young adults. Etiology remains unclear. But based on the frequent detection of chromosomic alterations, especially near the anaplastic lymphoma kinase (ALK) gene, IMT is now considered to be a true neoplasm.

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Background: In lung transplantation (LuTx), various ischemic phases exist, yet the rewarming ischemia time (RIT) during implantation has often been overlooked. During RIT, lungs are deflated and exposed to the body temperature in the recipient's chest cavity. Our prior clinical findings demonstrated that prolonged RIT increases the risk of primary graft dysfunction.

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Objectives: Historically, the perfusion-guided sequence suggests to first transplant the side with lowest lung perfusion. This sequence is thought to limit right ventricular afterload and prevent acute heart failure after first pneumonectomy. As a paradigm shift, we adopted the right-first implantation sequence, irrespective of lung perfusion.

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Background A surgical fellowship allows both additional training as well as maintenance of surgical skills while searching for a steady job. As the presence of fellows usually does not results in a measurably higher productivity, fellowshipsmay be considered a form of disguised unemployment. The aim of this study is to evaluate the career flow of a surgical trainee to a staff position and to determine the number of surgeons working on temporary basis within the general surgery workforce in Flanders.

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Objective: Harmonized European NSCLC incidence, treatment approach, and survival based on national tumor registries are unclear.

Summary Background Data: Surgery has the potential to cure NSCLC and significantly prolong survival. This large-scale international study aimed to investigate treatment variations in Europe and the USA, as well as the determinants for its utilization.

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Introduction: Compared with traditional static ice storage, controlled hypothermic storage (CHS) at 4-10°C may attenuate cold-induced lung injury between procurement and implantation. In this study, we describe the first European lung transplant (LTx) experience with a portable CHS device.

Methods: A prospective observational study was conducted of all consecutively performed LTx following CHS (11 November 2022 and 31 January 2024) at two European high-volume centers.

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Background: To identify intersegmental planes (ISPs) in video/robot-assisted thoracoscopic segmentectomies, indocyanine green (ICG) is commonly used. The aim of this systematic review is to evaluate the efficacy of intravenous ICG in the identification of ISP.

Methods: A systematic search was performed.

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Objectives: To assess the current practice of pulmonary metastasectomy at 15 European Centres. Short- and long-term outcomes were analysed.

Methods: Retrospective analysis on patients ≥18 years who underwent curative-intent pulmonary metastasectomy (January 2010 to December 2018).

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Objectives: Lung volume reduction surgery (LVRS) is an established therapeutic option for advanced emphysema. To improve patients' safety and reduce complications, an enhanced recovery protocol (ERP) was implemented. This study aims to describe and evaluate the short-term outcome of this ERP.

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Article Synopsis
  • Lung transplantations are complex and can lead to complications such as esophageal fistulas (EFs), though they are rare; this study reviewed cases at University Hospitals Leuven to investigate their clinical features and treatment approaches.
  • Among 212 lung transplant patients, 5 (2.4%) developed EFs, primarily presenting with respiratory infections; diagnosis occurred around 28 days post-surgery, using CT scans or esophagogastroscopy.
  • Surgical repair with muscle flap coverage showed an 80% success rate, highlighting the importance of early diagnosis and careful surgical technique to minimize risks and improve patient outcomes.
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Background: Extracorporeal life support (ECLS) is not routinely used at our center during sequential single-lung transplantation (LTx), but is restricted to anticipate and overcome hemodynamic and respiratory problems occurring peri-operatively. In this retrospective descriptive cohort study, we aim to describe our single-center experience with ECLS in LTx, analyzing ECLS-related complications.

Methods: All transplantations with peri-operative ECLS use [2010-2020] were retrospectively analyzed.

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Article Synopsis
  • Lung re-transplantation (re-LTx) is a treatment option for patients with serious lung graft issues, and this study focuses on the safety and feasibility of a less invasive surgical technique that avoids a clamshell incision.
  • A total of 42 patients were analyzed, with findings indicating that the off-pump method led to shorter surgery times and lower rates of severe primary graft dysfunction compared to more invasive techniques using clamshell incisions.
  • Both surgical approaches showed similar long-term survival rates, suggesting that the off-pump method could be a viable option for certain patients needing re-LTx.
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Background: In the treatment of Non-Small Cell Lung Cancer (NSCLC) the combination of Immuno- Oncotherapy (IO) and chemotherapy (CT) has been found to be superior to IO or CT alone for patients' survival. Patients and clinicians are confronted with a preference sensitive choice between a more aggressive treatment with a greater negative effect on quality of life versus alternatives that are less effective but have fewer side effects.

Objectives: The aims of this study were to: (a) quantify patients' preferences for relevant attributes related to Immuno-Oncotherapy treatment alternatives, and (b) evaluate the maximum acceptable risk (MAR)/Minimum acceptable benefit (MAB) that patients would accept for treatment alternatives.

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Objective: To describe our experience with lung transplantation (LTx) from donors ≥70 years and compare short and long-term outcomes to a propensity-matched cohort of donors <70 years.

Background: Although extended-criteria donors have been widely used to enlarge the donor pool, the experience with LTx from older donors (≥70 years) remains limited.

Methods: All single-center bilateral LTx between 2010 and 2020 were retrospectively analyzed.

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Background: Pulmonary metastasectomy (PM) with curative intent has become a widely accepted treatment for lung metastases from solid tumours in selected patients, with low perioperative morbidity and mortality. In particular, PM is strongly recommended in selected patients with secondary lesions from colorectal cancer (CRC), due to its excellent postoperative prognosis. Nevertheless, the impact of the extent of PM on recurrence and survival remains controversial.

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Background: Although most guidelines suggest performing a positron emission tomography/computed tomography (PET/CT) with somatostatin receptor (SSTR) ligands for staging of pulmonary carcinoid tumours (PC), only a limited number of studies have evaluated the role of this imaging tool in this specific patient population. The preoperative differentiation between typical carcinoid (TC) and atypical carcinoid (AC) and the extent of dissemination (N/M status) are crucial factors for treatment allocation and prognosis of these patients. Therefore, we performed a pathology-based retrospective analysis of the value of SSTR PET/CT in tumour grading and detection of nodal and metastatic involvement of PC and compared this with the previous literature and with [F]FDG PET/CT in a subgroup of patients.

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To investigate factors associated with the ability to receive adjuvant chemotherapy in patients with pathological N1 and N2 stage after anatomic lung resections for non-small cell lung cancer (NSCLC). Multicenter retrospective analysis on 707 consecutive patients found pathologic N1 (pN1) or N2 (pN2) disease following anatomic lung resections for NSCLC (2014-2019). Multiple imputation logistic regression was used to identify factors associated with adjuvant chemotherapy and to develop a model to predict the probability of starting this treatment.

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Article Synopsis
  • Organ transplantation faces challenges due to a lack of suitable organs, with "donation after cardio-circulatory death category V" (DCD-V) emerging as a potential solution following euthanasia.
  • A study of lung transplants from 2007 to 2020 showed that lung transplants from DCD-V donors had similar rates of primary graft dysfunction and chronic lung allograft dysfunction compared to those from DCD-III and donation after brain death (DBD) donors.
  • The findings suggest that lung transplants from DCD-V donors are both feasible and safe, with comparable patient survival rates, indicating that DCD-V could be a viable option in organ transplantation.
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Article Synopsis
  • Primary graft dysfunction (PGD) significantly impacts early recovery and survival rates after lung transplantation (LTx), with this study investigating the role of prolonged anastomosis time (AT) as a risk factor for PGD.
  • Data from 427 patients who underwent double lung transplants between 2008 and 2016 revealed that 30.2% developed severe PGD3 within 72 hours, and longer AT was independently linked to increased risk of PGD3.
  • The findings emphasize the importance of minimizing AT during LTx procedures and ensuring proper lung cooling to reduce the incidence of PGD and related complications.
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The technique for bronchial stump suturing following lung resection which is currently applied in the Department of Thoracic Surgery at the University Hospitals Leuven, Belgium owes its name to the Dutch surgeon Dr. Klinkenbergh (1891-1985). A true pioneer of cardiothoracic surgery in Europe, Dr.

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Background: The COVID-19 pandemic has tremendously impacted the healthcare system and residency programs worldwide. Surgical residents were redeployed to COVID-19 units, whereas education and scientific didactics were reduced. The aim of this study is to identify the impact of COVID-19 on Flemish surgical residents' education, personal life and volume of performed surgeries.

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Advanced treatment options for non-small cell lung cancer (NSCLC) consist of immunotherapy, chemotherapy, or a combination of both. Decisions surrounding NSCLC can be considered as preference-sensitive because multiple treatments exist that vary in terms of mode of administration, treatment schedules, and benefit-risk profiles. As part of the IMI PREFER project, we developed a protocol for an online preference survey for NSCLC patients exploring differences in preferences according to patient characteristics (preference heterogeneity).

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Background: Synovial sarcomas (SS) are malignant mesenchymal neoplasms that account for about 10% of all sarcomas. Complete surgical excision is the mainstay of primary treatment for localized disease, but SS have a high tendency for local relapse and metastases. Metastatic disease is commonly treated with systemic chemotherapy.

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Objectives: Mediastinal neurogenic tumours are uncommon and often benign neoplasms mostly located in the posterior mediastinum and usually diagnosed incidentally. We reviewed our results after surgical resection. We compared patient characteristics and tumour nature between children and adults.

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