PhD defence L.W.J. (Louis) Dossche

Below is a brief summary of the dissertation:

Congenital Lung Malformations (CLM) are increasingly detected prenatally due to routine fetal ultrasound screening. Although the majority of affected neonates are initially asymptomatic, the optimal treatment strategy and long-term outcomes have historically remained highly controversial due to a lack of prospective data. This thesis maps the clinical, functional, and radiological trajectory of CLM across the entire lifespan to replace institutional heterogeneity with standardized lifelong care.  
The overarching findings demonstrate that while affected children generally exhibit normal neurodevelopment and stable, though mildly altered, lung function over time, the clinical burden persists into adulthood. Adults with CLM exhibit chronic large- and small-airway obstruction alongside highly unpredictable volumetric progression or regression of the lesions on follow-up imaging. Crucially, there remains a rare but life-threatening risk of late-onset malignant transformation arising within the congenital pulmonary tissue.  
We demonstrated that discharging patients after childhood or relying solely on symptom-triggered care in adulthood is insufficient. Instead, this work establishes a unified framework for continuous lifelong management. It advocates for the implementation of standardized international diagnostic imaging guidelines and proactive, long-term pediatric and adult surveillance protocols. Ultimately, these overarching insights ensure a tailored, comprehensive care pathway that prioritizes patient safety from infancy through adulthood.