Aim To assess the prevalence and severity of short-term postoperative complications (≤30 days) following anorectal malformation (ARM) reconstruction, and explore potential risk factors for minor and major complications. Methods This retrospective cohort study included all ARM patients born between January 2000 and December 2025 who underwent definitive reconstruction. Short-term postoperative complications were classified according to the Clavien-Madadi classification. Univariable and multivariable logistic regression analyses were performed. Results 278 patients were included, of whom 49.6% were female. Median age (IQR) at reconstruction was 4 months (3–6). Short-term postoperative complications occurred in 78 patients (28.1%), including 53 (19.1%) minor and 25 (9.0%) major complications. Wound dehiscence occurred most frequently (n = 57; 20.5%). In multivariable analysis, surgical techniques other than ASARP or PSARP were associated with lower odds of minor complications (OR 0.14, 95% CI 0.03–0.62). Major complications were associated with VACTERL association (OR 6.27, 95% CI 2.43–16.22) and inversely with pre-reconstructive colostomy creation (OR 0.26, 95% CI 0.08–0.82). Conclusions Of all patients, 28.1% experienced short-term postoperative complications after ARM reconstruction. Minor complications were associated with type of surgery, whereas major complications were associated with VACTERL association and inversely with pre-reconstructive colostomy creation.
Background Primary cleft lip repair aims to restore both function and aesthetics of the nasolabial complex. Although several surgical techniques provide comparable functional outcomes, their long-term effects on facial symmetry remain unclear. This study compared postoperative facial symmetry following supraperiosteal and subperiosteal primary cleft lip repair using standardized photographic and digital anthropometric analysis. Methods This retrospective monocentric study included 46 patients with non-syndromic unilateral cleft lip and palate. Patients underwent either supraperiosteal repair or subperiosteal reconstruction. Standardized frontal photographs obtained at 0.5, 0.8, 6, and 10 years of age were analyzed. Facial asymmetry was evaluated by visual axis analysis and quantitative landmark-based measurements relative to predefined reference axes. Effect sizes were calculated using Cohen’s d. Results The subperiosteal repair group demonstrated consistently lower facial asymmetry and greater stability of symmetry development throughout follow-up than the supraperiosteal group. At 10 years, asymmetry of the cupid’s bow and lateral nasal wing was reduced by approximately 77% and 84%, respectively, while medial canthus asymmetry was reduced by 59%. The largest between-group differences were observed in the periorbital, nasal, and perioral regions, with large effect sizes for the medial canthus (d = 1.25), lateral nasal wing (d = 1.38), and cupid’s bow (d = 1.29). Conclusions Subperiosteal primary cleft lip repair was associated with improved long-term facial symmetry and greater stability of symmetry development over a 10-year follow-up period. Optimization of primary cleft lip repair techniques may improve long-term aesthetic outcomes and reduce the need for secondary corrective procedures.
Background:A brain tumor can lead to functional impairment, which is particularly concerning for adolescents and young adults (AYA). Patient-reported outcomes (PROs) have typically been examined as isolated domains, rather than as covarying symptoms. This study modeled PRO networks, symptom clustering, and topology among AYA oncology survivors. Methods:Patient-reported outcome networks from 4005 survivors were compared in topology between survivors of primary CNS tumors (n = 164) and non-CNS tumors (n = 3841). Survivors were diagnosed between 1999 and 2015 at ages 18 to 39 years, who completed the EORTC QLQ-SURV100 (Mdn follow-up = 12.31 years). Group-specific networks were estimated based on 33 health-related quality of life (HRQoL) scale scores using graphical LASSO. Wilcoxon rank-sum tests and the Network Comparison Test assessed group differences in the original PRO scales and their network centrality, respectively. Within the CNS subgroup (n = 164), associations with tumor-related and treatment-related characteristics were explored. Results:Survivors of central nervous system (CNS) tumors reported higher symptom burden on most PRO scales, along with a more diffuse network showing weaker within-domain cohesion (lower nodal strength and expected influence) and limited cross-domain integration (lower bridge strength). A small subset of nodes showed higher bridge expected influence (ie, fatigue, physical functioning, sexual problems when sexually active, work), which may represent key targets for intervention. Across both groups, negative health outlook, health distress, and physical functioning emerged as consistent core targets. Conclusion:Core symptoms may warrant prioritization in clinical follow-up and treatment of cancer survivors. These findings contribute to further development and optimization of tailored neurorehabilitation programs in neuro-oncological care.
Research on the social networks of children with posttraumatic stress disorder (PTSD) remains limited. Although a link between PTSD symptoms and the child's social environment is often assumed, this can be impacted in cases of interpersonal trauma. This is important, because social support can play a beneficial role in recovery after experiencing trauma. However, little is known about how children with interpersonal trauma perceive their social network and the support they gain from this network. This qualitative study used semi-structured interviews to explore these perceptions in greater depth. Ten children who experienced interpersonal trauma between the ages of 8 to 12 were interviewed about their social network. The content of the interviews was analyzed using reflexive thematic analysis. Descriptive statistics showed that children had varied networks with 40% of relationships experienced as ambivalent or negative. In addition, there was a general tendency to not discuss their traumatic experiences. Thematic analysis identified four key themes. First of all, the parent-child relationship was often strained with both parents, but in different ways. Second, there seemed to be a contrast between the positive definition children gave of friendship and the negative experiences they had within their own reported friendships. Third, children were able to identify supportive actions from different individuals in their network, related to the trauma as well as more general support. Finally, children reported various reasons for their general reluctance to discuss their trauma. The findings emphasize a need for help with strengthening the children's social network to improve recovery from trauma.
