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Article: Systemic Inflammatory Response and the Noble and Underwood (NUn) Score as Early Predictors of Anastomotic Leakage after Esophageal Reconstructive Surgery.

Van Daele, Elke / Vanommeslaeghe, Hanne / Decostere, Flo / Beckers Perletti, Louise / Beel, Esther / Van Nieuwenhove, Yves / Ceelen, Wim / Pattyn, Piet

Journal of clinical medicine

2024 Volume 13, Issue 3

Abstract: Anastomotic leakage (AL) remains the main cause of post-esophagectomy morbidity and mortality. Early detection can avoid sepsis and reduce morbidity and mortality. This study evaluates the diagnostic accuracy of the Nun score and its components as early ... ...

Abstract	Anastomotic leakage (AL) remains the main cause of post-esophagectomy morbidity and mortality. Early detection can avoid sepsis and reduce morbidity and mortality. This study evaluates the diagnostic accuracy of the Nun score and its components as early detectors of AL. This single-center observational cohort study included all esophagectomies from 2010 to 2020. C-reactive protein (CRP), albumin (Alb), and white cell count (WCC) were analyzed and NUn scores were calculated. The area under the curve statistic (AUC) was used to assess their predictive accuracy. A total of 74 of the 668 patients (11%) developed an AL. CRP and the NUn-score proved to be good diagnostic accuracy tests on postoperative day (POD) 2 (CRP AUC: 0.859; NUn score AUC: 0.869) and POD 4 (CRP AUC: 0.924; NUn score AUC: 0.948). A 182 mg/L CRP cut-off on POD 4 yielded a 87% sensitivity, 88% specificity, a negative predictive value (NPV) of 98%, and a positive predictive value (PPV) of 47.7%. A NUn score cut-off > 10 resulted in 92% sensitivity, 95% specificity, 99% NPV, and 68% PPV. Albumin and WCC have limited value in the detection of post-esophagectomy AL. Elevated CRP and a high NUn score on POD 4 provide high accuracy in predicting AL after esophageal cancer surgery. Their high negative predictive value allows to select patients who can safely proceed with enhanced recovery protocols.
Language	English
Publishing date	2024-01-31
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm13030826
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Article ; Online: Quality of Life after Minimally Invasive Esophagectomy: A Cross-Sectional Study.

Van Daele, Elke / Stuer, Eefje / Vanommeslaeghe, Hanne / Ceelen, Wim / Pattyn, Piet / Pape, Eva

Digestive surgery

2022 Volume 39, Issue 4, Page(s) 153–161

Abstract: Introduction: Surgery remains essential in the curative treatment of esophageal cancer (EC), but it is known for its high morbidity and impaired health-related QoL. Minimally invasive esophagectomy (MIE) was introduced to reduce surgical trauma and ... ...

Abstract	Introduction: Surgery remains essential in the curative treatment of esophageal cancer (EC), but it is known for its high morbidity and impaired health-related QoL. Minimally invasive esophagectomy (MIE) was introduced to reduce surgical trauma and improve QoL. Methods: This cross-sectional study aimed to evaluate long-term HRQoL after MIE in comparison with the general population. HRQoL assessment was based on three questionnaires: the European Organisation for Research and Treatment of Cancer (EORTC) Core 30 (QLQ-C30, version 3), the EORTC QLQ Oesophago Gastric 25 (QLQ-OG25), and the Supportive Care Needs Survey-Short Form 34 (SCNS-SF34). Results were compared to a healthy reference population. Results: One hundred and forty eligible MIE patients were identified, of whom met the inclusion criteria, and 49 completed all questionnaires. Patients reported a significantly better mean score on the global health status and QoL than the healthy reference population (71.5 ± 15.1 vs. 66.1 ± 21.7; p = 0.016). However, patients scored significantly worse about functioning (physical, role, and social) (p < 0.05), fatigue (p = 0.021), eating, dysphagia, pain and discomfort, reflux, appetite loss, weight loss, coughing, and taste (p < 0.001). Discussion/conclusion: EC survivors can reach a high global health status and QoL at least 1 year after MIE, despite long-term functional, nutritional, and gastrointestinal complaints. Patients provided written informed consent, and the study protocol was approved by the Ethics Committee of Ghent University Hospital (identifier: ID B670201940737).
MeSH term(s)	Humans ; Quality of Life ; Cross-Sectional Studies ; Esophagectomy/adverse effects ; Esophagectomy/methods ; Gastroesophageal Reflux ; Esophageal Neoplasms/surgery ; Surveys and Questionnaires
Language	English
Publishing date	2022-09-01
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	605888-7
ISSN	1421-9883 ; 0253-4886
ISSN (online)	1421-9883
ISSN	0253-4886
DOI	10.1159/000526832
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Article ; Online: Conservative management of spontaneous intra-abdominal abscess in Crohn's disease: Outcome and prognostic factors.

Waked, Bruno / Holvoet, Tom / Geldof, Jeroen / Baert, Filip / Pattyn, Piet / Lobatón, Triana / Hindryckx, Pieter

Journal of digestive diseases

2021 Volume 22, Issue 5, Page(s) 263–270

Abstract: Objective: To compare the outcomes of different treatments for spontaneous intra-abdominal abscesses (IAA) in active Crohn's disease (CD).: Methods: A retrospective analysis of patients with CD between January 2007 and December 2018 was performed in ... ...

Abstract	Objective: To compare the outcomes of different treatments for spontaneous intra-abdominal abscesses (IAA) in active Crohn's disease (CD). Methods: A retrospective analysis of patients with CD between January 2007 and December 2018 was performed in two Belgian inflammatory bowel disease centers. Successful conservative management was defined as complete resolution of abscesses without the need for bowel resection. The primary outcome was suboptimal evolution, defined as a composite outcome of recurrence of abscess, postoperative complications or the need for a non-elective resection. Results: Forty CD patients presenting with 43 independent episodes of spontaneous IAA development were included. One underwent immediate bowel resection. In all other 42 cases a conservative approach was taken, which led to a complete abscess resolution rate of 28.6% (12/42). The remaining abscesses required bowel resection. Anti-tumor necrosis factor (TNF) agent use was associated with successful conservative management (odds ratio [OR] 13.36, 95% confidence interval [CI] 11.19-15.52, P = 0.006), while the opposite trend was found for corticosteroids (OR 0.14, 95% CI 0.02-1.26, P = 0.055). There was a trend towards suboptimal evolution in case of previous bowel resection (OR 4.77, 95% CI 0.77-29.66, P = 0.094) or in patients aged above 50 years (OR 5.17, 95% CI 0.86-30.91, P = 0.072). Conclusions: Bowel resection appears to be inevitable in most CD patients presenting with IAA. An attempt at conservative treatment may be particularly successful with anti-TNF agents in younger patients who have not undergone previous bowel resection. Large-scale prospective studies are needed to confirm these findings.
MeSH term(s)	Abdominal Abscess ; Aged ; Conservative Treatment ; Crohn Disease ; Drainage ; Humans ; Prognosis ; Prospective Studies ; Retrospective Studies ; Treatment Outcome ; Tumor Necrosis Factor Inhibitors
Chemical Substances	Tumor Necrosis Factor Inhibitors
Language	English
Publishing date	2021-04-16
Publishing country	Australia
Document type	Journal Article
ZDB-ID	2317117-0
ISSN	1751-2980 ; 1751-2972
ISSN (online)	1751-2980
ISSN	1751-2972
DOI	10.1111/1751-2980.12984
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Article: Symptomatic gastric involvement in a parastomal hernia: uncommon presentation.

Vierstraete, Maaike / Van de Putte, Dirk / Pattyn, Piet

Acta chirurgica Belgica

2018 Volume 120, Issue 1, Page(s) 57–60

Abstract: Introduction: ...

Abstract	Introduction:
MeSH term(s)	Aged ; Colostomy/adverse effects ; Female ; Humans ; Incisional Hernia/diagnostic imaging ; Incisional Hernia/etiology ; Incisional Hernia/surgery ; Stomach Diseases/diagnostic imaging ; Stomach Diseases/etiology ; Stomach Diseases/surgery ; Surgical Stomas/adverse effects ; Tomography, X-Ray Computed
Language	English
Publishing date	2018-08-14
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	210274-2
ISSN	0001-5458
ISSN	0001-5458
DOI	10.1080/00015458.2018.1500800
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Article ; Online: Clinical utility of near-infrared perfusion assessment of the gastric tube during Ivor Lewis esophagectomy.

Van Daele, Elke / De Bruyne, Naomi / Vanommeslaeghe, Hanne / Van Nieuwenhove, Yves / Ceelen, Wim / Pattyn, Piet

Surgical endoscopy

2022 Volume 36, Issue 8, Page(s) 5812–5821

Abstract: Background: Anastomotic leakage (AL) after Ivor Lewis esophagectomy with intrathoracic anastomosis carries a significant morbidity. Adequate perfusion of the gastric tube (GT) is an important predictor of anastomotic integrity. Recently, near infrared ... ...

Abstract	Background: Anastomotic leakage (AL) after Ivor Lewis esophagectomy with intrathoracic anastomosis carries a significant morbidity. Adequate perfusion of the gastric tube (GT) is an important predictor of anastomotic integrity. Recently, near infrared fluorescent (NIRF) imaging using indocyanine green (ICG) was introduced in clinical practice to evaluate tissue perfusion. We evaluated the feasibility and efficacy of GT indocyanine green angiography (ICGA) after Ivor Lewis esophagectomy. Methods: This retrospective analysis used data from a prospectively kept database of consecutive patients who underwent Ivor Lewis (IL) esophagectomy with GT construction for cancer between January 2016 and December 2020. Relevant outcomes were feasibility, ICGA complications and the impact of ICGA on AL. Results: 266 consecutive IL patients were identified who matched the inclusion criteria. The 115 patients operated with perioperative ICGA were compared to a control group in whom surgery was performed according to the standard of care. ICGA perfusion assessment was feasible and safe in all 115 procedures and suggested a poorly perfused tip in 56/115 (48.7%) cases, for which additional resection was performed. The overall AL rate was 16% (43/266), with 12% (33/266) needing an endoscopic our surgical intervention and 6% (17/266) needing ICU support. In univariable and multivariable analyses, ICGA was not correlated with the risk of AL (ICGA:14.8% vs non-ICGA:17.2%, p = 0.62). However, poor ICGA perfusion of the GT predicted a higher AL rate, despite additional resection of the tip (ICGA poorly perfused: 19.6% vs ICG well perfused: 10.2%, p = 0.19). Conclusions: ICGA is safe and feasible, but did not result in a reduction of AL. The interpretation and necessary action in case of perioperative presence of ischemia on ICGA have yet to be determined. Prospective randomized trials are warranted to analyze its benefit on AL in esophageal surgery. Trial registration Ethical approval for a prospective esophageal surgery database was granted by the Ethical committee of the Ghent University Hospital. Belgian registration number: B670201111232. Ethical approval for this retrospective data analysis was granted by our institutional EC. Registration number: BC-09216.
MeSH term(s)	Anastomosis, Surgical/methods ; Anastomotic Leak/etiology ; Anastomotic Leak/prevention & control ; Anastomotic Leak/surgery ; Esophageal Neoplasms/complications ; Esophageal Neoplasms/diagnostic imaging ; Esophageal Neoplasms/surgery ; Esophagectomy/methods ; Humans ; Indocyanine Green ; Perfusion ; Prospective Studies ; Retrospective Studies
Chemical Substances	Indocyanine Green (IX6J1063HV)
Language	English
Publishing date	2022-02-14
Publishing country	Germany
Document type	Journal Article
ZDB-ID	639039-0
ISSN	1432-2218 ; 0930-2794
ISSN (online)	1432-2218
ISSN	0930-2794
DOI	10.1007/s00464-022-09091-3
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Article ; Online: Patient-reported outcomes after pelvic exenteration for colorectal cancer: A systematic review.

Denys, Andreas / van Nieuwenhove, Yves / Van de Putte, Dirk / Pape, Eva / Pattyn, Piet / Ceelen, Wim / van Ramshorst, Gabriëlle H

Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland

2022 Volume 24, Issue 4, Page(s) 353–368

Abstract: Aim: Pelvic exenteration (PE) carries high morbidity. Our aim was to analyse the use of patient-reported outcome measures (PROMs) in PE patients.: Method: Search strategies were protocolized and registered in PROSPERO. PubMed, Embase, Cochrane ... ...

Abstract	Aim: Pelvic exenteration (PE) carries high morbidity. Our aim was to analyse the use of patient-reported outcome measures (PROMs) in PE patients. Method: Search strategies were protocolized and registered in PROSPERO. PubMed, Embase, Cochrane Library, Google Scholar, Web of Science and ClinicalTrials.gov were searched with the terms 'patient reported outcomes', 'pelvic exenteration' and 'colorectal cancer'. Studies published after 1980 reporting on PROMs for at least 10 PE patients were considered. Study selection, data extraction, rating of certainty of evidence (GRADE) and risk of bias (ROBINS-I) were performed independently by two reviewers. Results: Nineteen of 173 studies were included (13 retrospective, six prospective). All studies were low to very low quality, with an overall moderate/serious risk of bias. Studies included data on 878 patients with locally advanced rectal cancer (n = 344), recurrent rectal cancer (n = 411) or cancer of unknown type (n = 123). Thirteen studies used validated questionnaires, four used non-validated measures and two used both. Questionnaires included the Functional Assessment of Cancer Therapy-Colorectal questionnaire (n = 6), Short Form Health Survey (n = 6), European Organization for Research and Treatment for Cancer (EORTC) Quality of Life Questionnaire C30 (n = 6), EORTC-CR38 (n = 4), EORTC-BLM30 (n = 1), Brief Pain Inventory (n = 2), Short Form 12 (n = 1), Assessment of Quality of Life (n = 1), Short Form Six-Dimension (n = 1), the Memorial Sloan Kettering Cancer Center Sphincter Function Scale (n = 1), the Cleveland Global Quality of Life (n = 1) or other (n = 4). Timing varied between studies. Conclusions: Whilst the use of validated questionnaires increased over time, this study shows that there is a need for uniform use and timing of PROMs to enable multicentre studies.
MeSH term(s)	Humans ; Neoplasm Recurrence, Local/surgery ; Patient Reported Outcome Measures ; Pelvic Exenteration/methods ; Prospective Studies ; Quality of Life ; Rectal Neoplasms/surgery ; Retrospective Studies
Language	English
Publishing date	2022-01-30
Publishing country	England
Document type	Journal Article ; Review ; Systematic Review
ZDB-ID	1440017-0
ISSN	1463-1318 ; 1462-8910
ISSN (online)	1463-1318
ISSN	1462-8910
DOI	10.1111/codi.16028
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Article ; Online: Post-operative minimal residual disease models to study metastatic relapse in soft-tissue sarcoma patient-derived xenografts.

Fischer, Suzanne / Creytens, David / De Geyter, Sofie / De Vlieghere, Elly / Pattyn, Piet / Bekaert, Sarah-Lee / Durinck, Kaat / Van Roy, Nadine / Hendrix, An / Lapeire, Lore / Sys, Gwen / De Wever, Olivier

Clinical and translational medicine

2023 Volume 13, Issue 6, Page(s) e1290

MeSH term(s)	Animals ; Humans ; Neoplasm, Residual ; Heterografts ; Neoplasm Recurrence, Local ; Sarcoma/pathology ; Sarcoma/surgery ; Soft Tissue Neoplasms/pathology ; Soft Tissue Neoplasms/surgery ; Disease Models, Animal
Language	English
Publishing date	2023-06-07
Publishing country	United States
Document type	Letter
ZDB-ID	2697013-2
ISSN	2001-1326 ; 2001-1326
ISSN (online)	2001-1326
ISSN	2001-1326
DOI	10.1002/ctm2.1290
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Article ; Online: Evaluation of a marker independent isolation method for circulating tumor cells in esophageal adenocarcinoma.

Philippron, Annouck / Depypere, Lieven / Oeyen, Steffi / De Laere, Bram / Vandeputte, Charlotte / Nafteux, Philippe / De Preter, Katleen / Pattyn, Piet

PloS one

2021 Volume 16, Issue 5, Page(s) e0251052

Abstract: Objective: The enrichment of circulating tumor cells (CTCs) from blood provides a minimally invasive method for biomarker discovery in cancer. Longitudinal interrogation allows monitoring or prediction of therapy response, detection of minimal residual ... ...

Abstract	Objective: The enrichment of circulating tumor cells (CTCs) from blood provides a minimally invasive method for biomarker discovery in cancer. Longitudinal interrogation allows monitoring or prediction of therapy response, detection of minimal residual disease or progression, and determination of prognosis. Despite inherent phenotypic heterogeneity and differences in cell surface marker expression, most CTC isolation technologies typically use positive selection. This necessitates the optimization of marker-independent CTC methods, enabling the capture of heterogenous CTCs. The aim of this report is to compare a size-dependent and a marker-dependent CTC-isolation method, using spiked esophageal cells in healthy donor blood and blood from patients diagnosed with esophageal adenocarcinoma. Methods: Using esophageal cancer cell lines (OE19 and OE33) spiked into blood of a healthy donor, we investigated tumor cell isolation by Parsortix post cell fixation, immunostaining and transfer to a glass slide, and benchmarked its performance against the CellSearch system. Additionally, we performed DEPArray cell sorting to infer the feasibility to select and isolate cells of interest, aiming towards downstream single-cell molecular characterization in future studies. Finally, we measured CTC prevalence by Parsortix in venous blood samples from patients with various esophageal adenocarcinoma tumor stages. Results: OE19 and OE33 cells were spiked in healthy donor blood and subsequently processed using CellSearch (n = 16) or Parsortix (n = 16). Upon tumor cell enrichment and enumeration, the recovery rate ranged from 76.3 ± 23.2% to 21.3 ± 9.2% for CellSearch and Parsortix, respectively. Parsortix-enriched and stained cell fractions were successfully transferred to the DEPArray instrument with preservation of cell morphology, allowing isolation of cells of interest. Finally, despite low CTC prevalence and abundance, Parsortix detected traditional CTCs (i.e. cytokeratin+/CD45-) in 8/29 (27.6%) of patients with esophageal adenocarcinoma, of whom 50% had early stage (I-II) disease. Conclusions: We refined an epitope-independent isolation workflow to study CTCs in patients with esophageal adenocarcinoma. CTC recovery using Parsortix was substantially lower compared to CellSearch when focusing on the traditional CTC phenotype with CD45-negative and cytokeratin-positive staining characteristics. Future research could determine if this method allows downstream molecular interrogation of CTCs to infer new prognostic and predictive biomarkers on a single-cell level.
MeSH term(s)	Adenocarcinoma/blood ; Adenocarcinoma/pathology ; Aged ; Aged, 80 and over ; Biomarkers, Tumor ; Cell Line, Tumor ; Cell Separation/methods ; Esophageal Neoplasms/blood ; Esophageal Neoplasms/pathology ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Neoplastic Cells, Circulating/pathology ; Prognosis
Chemical Substances	Biomarkers, Tumor
Language	English
Publishing date	2021-05-07
Publishing country	United States
Document type	Journal Article
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0251052
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Article ; Online: Comprehensive RNA dataset of tissue and plasma from patients with esophageal cancer or precursor lesions.

Schoofs, Kathleen / Philippron, Annouck / Avila Cobos, Francisco / Koster, Jan / Lefever, Steve / Anckaert, Jasper / De Looze, Danny / Vandesompele, Jo / Pattyn, Piet / De Preter, Katleen

Scientific data

2022 Volume 9, Issue 1, Page(s) 86

Abstract: In the past decades, the incidence of esophageal adenocarcinoma has increased dramatically in Western populations. Better understanding of disease etiology along with the identification of novel prognostic and predictive biomarkers are urgently needed to ...

Abstract	In the past decades, the incidence of esophageal adenocarcinoma has increased dramatically in Western populations. Better understanding of disease etiology along with the identification of novel prognostic and predictive biomarkers are urgently needed to improve the dismal survival probabilities. Here, we performed comprehensive RNA (coding and non-coding) profiling in various samples from 17 patients diagnosed with esophageal adenocarcinoma, high-grade dysplastic or non-dysplastic Barrett's esophagus. Per patient, a blood plasma sample, and a healthy and disease esophageal tissue sample were included. In total, this comprehensive dataset consists of 102 sequenced libraries from 51 samples. Based on this data, 119 expression profiles are available for three biotypes, including miRNA (51), mRNA (51) and circRNA (17). This unique resource allows for discovery of novel biomarkers and disease mechanisms, comparison of tissue and liquid biopsy profiles, integration of coding and non-coding RNA patterns, and can serve as a validation dataset in other RNA landscaping studies. Moreover, structural RNA differences can be identified in this dataset, including protein coding mutations, fusion genes, and circular RNAs.
MeSH term(s)	Adenocarcinoma/blood ; Adenocarcinoma/genetics ; Barrett Esophagus/blood ; Barrett Esophagus/genetics ; Biomarkers ; Disease Progression ; Esophageal Neoplasms/blood ; Esophageal Neoplasms/genetics ; Humans ; MicroRNAs/genetics ; Plasma/metabolism
Chemical Substances	Biomarkers ; MicroRNAs
Language	English
Publishing date	2022-03-14
Publishing country	England
Document type	Dataset ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2775191-0
ISSN	2052-4463 ; 2052-4463
ISSN (online)	2052-4463
ISSN	2052-4463
DOI	10.1038/s41597-022-01176-x
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Article ; Online: Information and counselling needs of patients with major low anterior resection syndrome: A qualitative study.

Pape, Eva / Decoene, Elsie / Debrauwere, Mieke / Van Nieuwenhove, Yves / Pattyn, Piet / Feryn, Tom / Pattyn, Paul R L / Verhaeghe, Sofie / Van Hecke, Ann

Journal of clinical nursing

2022 Volume 32, Issue 7-8, Page(s) 1240–1250

Abstract: Aims and objectives: The aim was to explore the information and counselling needs of rectal cancer survivors confronted with major low anterior resection syndrome.: Background: Rectal cancer survivors are often confronted with bowel problems after ... ...

Abstract	Aims and objectives: The aim was to explore the information and counselling needs of rectal cancer survivors confronted with major low anterior resection syndrome. Background: Rectal cancer survivors are often confronted with bowel problems after surgery. This is called low anterior resection syndrome. Patients are unsure what to expect after treatment and healthcare professionals often underestimate the impact of low anterior resection syndrome on patients' lives. Design: A qualitative study with a grounded theory approach was conducted. Methods: Patients were recruited between 2017 and 2019 in three hospitals, and a call was distributed in two patients' organisations. Semi-structured interviews with patients confronted with major low anterior resection syndrome were performed. An iterative process between data collection and data analysis was used. Data analysis was done using the constant comparative method, and investigators' triangulation was applied. Qualitative data were reported following COREQ guidelines. The study was registered at Clinicaltrials.gov NCT04896879. Results: A total of 28 patients were interviewed until theoretical data saturation. Before surgery patients' need for information varied according to their individual coping mechanisms. Some patients required information before surgery, while others considered this too overwhelming. When confronted with LARS, patients desired that healthcare professionals recognised its impact and clarified its expected evolution. A proactive counselling with an easy accessible and approachable healthcare professional was beneficial. Conclusion: Patients expressed several needs regarding the information before rectal cancer surgery and counselling of low anterior resection syndrome after surgery. Relevance to clinical practice: Better knowledge and understanding of major low anterior resection syndrome and its challenges by healthcare professionals are crucial. Especially the impact on quality of life is significant for patients and underestimated by healthcare professionals. Information before surgery and counselling when confronted with major low anterior resection syndrome should be optimised and tailored to patients' needs.
MeSH term(s)	Humans ; Counseling ; Low Anterior Resection Syndrome ; Postoperative Complications ; Quality of Life ; Rectal Neoplasms/surgery
Language	English
Publishing date	2022-03-06
Publishing country	England
Document type	Clinical Trial ; Journal Article
ZDB-ID	1159483-4
ISSN	1365-2702 ; 0962-1067 ; 1752-9816
ISSN (online)	1365-2702
ISSN	0962-1067 ; 1752-9816
DOI	10.1111/jocn.16277
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