title: Role of prophylactic surgical ligation of patent ductus arteriosus in extremely low birth weight infants: Systematic review and implications for clinical practice.
abstract: OBJECTIVE
  To investigate the effectiveness and safety of prophylactic surgical ligation of patent ductus arteriosus (PDA) on mortality and morbidity of preterm infants weighing less than 1000 g at birth.
  
  
  METHODS
  The study conducted a systematic search of available database from 1996-2008. Retrieved articles were assessed for eligibility and data was abstracted independently by two reviewers. Decisions to include studies for review and the methodological quality of included studies were asssessed in duplicate based on predetermined criteria. No language restrictions were applied.
  
  
  RESULTS
  Only one eligible study that enrolled 84 extremely low birth weight infants was identified. Prophylactic surgical ligation of PDA resulted in a statistically significant reduction of severe stage II or III necrotizing enterocolitis, [RR 0.25, 95% CI (0.08, 0.83), P value 0.02, number needed to treat 5]. The study, however, found no statistically significant difference in mortality, intraventricular hemorrhage, bronchopulmonary dysplasia, and retinopathy of prematurity.
  
  
  CONCLUSIONS
  Current evidence does not support the use of prophylactic surgical ligation of PDA in the management of the preterm infants.
authors.affiliation: Departments of Pediatrics, Omm Al-Qura University, Mecca.
authors.forename: Rafat
authors.initials: R
authors.lastname: Mosalli
authors.forename: Khalid
authors.initials: K
authors.lastname: Alfaleh
authors.forename: Bosco
authors.initials: B
authors.lastname: Paes
references.citation: Curr Opin Pediatr. 2004 Apr;16(2):146-51
references.pmid: 15021192
references.citation: Arch Dis Child Fetal Neonatal Ed. 2007 Nov;92(6):F424-7
references.pmid: 17951547
references.citation: Dev Pharmacol Ther. 1980;1(2-3):125-36
references.pmid: 6765467
references.citation: Surg Today. 1998;28(12):1290-4
references.pmid: 9872552
references.citation: Arch Dis Child Fetal Neonatal Ed. 2003 Nov;88(6):F477-82
references.pmid: 14602694
references.citation: N Engl J Med. 2001 Jun 28;344(26):1966-72
references.pmid: 11430325
references.citation: J Pediatr. 2000 Jul;137(1):68-72
references.pmid: 10891824
references.citation: J Pediatr. 1978 Oct;93(4):647-51
references.pmid: 702245
references.citation: Cochrane Database Syst Rev. 2002;(3):CD000174
references.pmid: 12137607
references.citation: Ann Surg. 1978 Jan;187(1):1-7
references.pmid: 413500
references.citation: Semin Neonatol. 2003 Feb;8(1):63-71
references.pmid: 12667831
references.citation: Cochrane Database Syst Rev. 2008 Jan 23;(1):CD003481
references.pmid: 18254020
references.citation: Pediatrics. 2003 Jul;112(1 Pt 1):33-9
references.pmid: 12837865
references.citation: J Pediatr. 1978 Apr;92(4):529-34
references.pmid: 305471
references.citation: Pediatrics. 2008 Feb;121(2):e233-8
references.pmid: 18245398
references.citation: Early Hum Dev. 1991 Nov;27(1-2):65-77
references.pmid: 1802665
references.citation: Am J Perinatol. 2009 Mar;26(3):235-45
references.pmid: 19067286
references.citation: Acta Paediatr. 2006 Apr;95(4):394-403
references.pmid: 16720484
references.citation: J Pediatr. 1983 Jun;102(6):895-906
references.pmid: 6343572
references.citation: Pediatrics. 1994 Apr;93(4):543-50
references.pmid: 8134206
references.citation: Cochrane Database Syst Rev. 2003;(2):CD003745
references.pmid: 12804488
references.citation: Clin Perinatol. 1995 Jun;22(2):457-79
references.pmid: 7671547
references.citation: J Pediatr. 2007 Jan;150(1):46-50.e2
references.pmid: 17188612
references.citation: N Engl J Med. 1972 Sep 7;287(10):473-7
references.pmid: 5048708
references.citation: J Pediatr. 1996 May;128(5 Pt 1):601-7
references.pmid: 8627430
references.citation: J Pediatr. 1984 Jun;104(6):915-20
references.pmid: 6726527
references.citation: Arch Dis Child Fetal Neonatal Ed. 2007 Nov;92(6):F498-502
references.pmid: 17951552
references.citation: J Perinatol. 2007 Mar;27(3):164-70
references.pmid: 17251985
references.citation: Pediatrics. 2009 Mar;123(3):1037-44
references.pmid: 19255037
references.citation: J Pediatr Surg. 1993 Sep;28(9):1137-9
references.pmid: 8308678
references.citation: N Engl J Med. 1989 Jun 8;320(23):1511-6
references.pmid: 2498657
references.citation: J Pediatr. 1994 Aug;125(2):270-7
references.pmid: 8040777
references.citation: Acta Anaesthesiol Sin. 1999 Jun;37(2):89-92
references.pmid: 10410409
references.citation: J Pediatr. 1982 Oct;101(4):587-93
references.pmid: 7119964
references.citation: Arch Dis Child. 1991 Apr;66(4):477-80
references.pmid: 1812843
references.citation: J Pediatr. 1995 Apr;126(4):605-10
references.pmid: 7699543
references.citation: J Pediatr. 1978 Mar;92(3):467-73
references.pmid: 632994
references.citation: J Pediatr. 1979 Nov;95(5 Pt 2):865-6
references.pmid: 490263
references.citation: J Pediatr. 1999 Dec;135(6):733-8
references.pmid: 10586177
references.citation: Pediatrics. 2003 Apr;111(4 Pt 1):e340-6
references.pmid: 12671149
references.citation: J Pediatr Surg. 2007 Jan;42(1):69-75; discussion 75
references.pmid: 17208543
references.citation: Pediatrics. 2007 Jun;119(6):1165-74
references.pmid: 17545385
references.citation: J Pediatr Surg. 1987 Dec;22(12):1171-4
references.pmid: 3440906
references.citation: J Pediatr. 2007 Mar;150(3):229-34, 234.e1
references.pmid: 17307535
references.citation: Cochrane Database Syst Rev. 2008 Jan 23;(1):CD003951
references.pmid: 18254035
references.citation: J Thorac Cardiovasc Surg. 1984 Jun;87(6):870-5
references.pmid: 6374300
references.citation: J Pediatr. 1993 Jun;122(6):S59-62
references.pmid: 8501549
references.citation: Eur J Pediatr. 1999 Jun;158(6):484-7
references.pmid: 10378397
references.citation: Pediatr Res. 1998 May;43(5):633-44
references.pmid: 9585010