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Risk factors for the development of subretinal fluid in the fellow eyes of patients with chronic central serous chorioretinopathy.

Authors: Feenstra HMA, Cakar T, Brinks J, Boon CJF, van Dijk EHC
Journal: Acta ophthalmologica
mental health psychology open access

Abstract

Advances in pediatric hematology‐oncology have significantly improved survival rates, making supportive surgical care and postoperative management increasingly important []. Pediatric cancer therapy is multimodal, often requiring surgical interventions for diagnosis (biopsies) and treatment (central venous access device [CVAD] placement, tumor resections, debulking) alongside chemotherapy, immunotherapy, or radiation. These patients present unique challenges in the postoperative period due to the effects of their disease and its treatment: immunosuppression from chemotherapy, thrombocytopenia and coagulopathies, organ dysfunction, and poor wound healing []. Consequently, they face higher risks of complications such as infections and bleeding than other surgical populations. Pediatric surgeons play a pivotal role in the multidisciplinary team, contributing to diagnosis, staging, definitive tumor resection, central line placement, and management of complications [, ]. Close collaboration between surgeons, pediatric oncologists/hematologists, anesthesiologists, critical care specialists, and nursing is essential for optimal postoperative outcomes. Multidisciplinary tumor boards and co‐management strategies have been shown to improve decision‐making and even survival in pediatric oncology care []. In this review, we outline the common surgical procedures encountered in pediatric hematology‐oncology patients and detail evidence‐based postoperative care and complication management. We highlight common and rare postoperative complications and describe emerging innovations aimed at improving recovery. Throughout, the emphasis is on a comprehensive, team‐based approach to ensure safe surgery and timely continuation of oncologic therapy for children with cancer.