title: [Surgical closure of patent ductus arteriosus in premature neonates: Does the surgical technique affect the outcome?]
abstract: BACKGROUND
  Surgical closure of patent ductus arteriosus in premature neonates is an aggressive technique and is not free of complications. A study was designed with the aim of describing our experience with a less invasive technique, the extra-pleural approach via a posterior minithoracotomy, and to compare the results with the classic transpleural approach.
  
  
  METHODS
  A retrospective cohort study was conducted on premature neonates on whom surgical closure of the ductus was performed during a ten-year period (March 2005 to March 2015). A comparison was made of the acute complications, the outcomes on discharge, and follow-up, between the extra-pleural approach and the classic transpleural approach. The study included 48 patients, 30 in the classical approach and 18 in the extra-pleural group.
  
  
  RESULTS
  The demographic and pre-operative characteristics were similar in both groups. No differences were found between the 2 groups in the incidence of acute post-operative complications (56.6 vs. 44.4%), on the dependence on oxygen at 36 weeks (33.3 vs. 55.5%), or in hospital mortality (10 vs. 16.6%). As regards the short-term progress, the extra-pleural group required fewer days until the withdrawal of supplementary oxygen (36.3 vs. 28.9) and until hospital discharge (67.5 vs. 53.2), although only the time until extubation achieved a statistically significant difference (11.5 vs. 2.7, P=.03).
  
  
  CONCLUSIONS
  The extra-plural approach by posterior minithoracotomy for the surgical closure of ductus in the premature infant is viable and could bring some clinical benefits in the short-term.
authors.affiliation: Unidad de Neonatología, Servicio de Pediatría, Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas, A Coruña, España; Cardiopatía Estructural y Congénita (CEC), Instituto de Investigación Biomédica de A Coruña (INIBIC), A Coruña, España. Electronic address: alejandro.avila.neonatologia@gmail.com.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Avila-Alvarez
authors.affiliation: Unidad de Neonatología, Servicio de Pediatría, Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas, A Coruña, España.
authors.forename: Marta
authors.initials: M
authors.lastname: Serantes Lourido
authors.affiliation: Unidad de Neonatología, Servicio de Pediatría, Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas, A Coruña, España.
authors.forename: Rebeca
authors.initials: R
authors.lastname: Barriga Bujan
authors.affiliation: Unidad de Cardiología Infantil, Servicio de Pediatría, Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas, A Coruña, España.
authors.forename: Carolina
authors.initials: C
authors.lastname: Blanco Rodriguez
authors.affiliation: Servicio de Cirugía Cardiaca, Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas, A Coruña, España; Cardiopatía Estructural y Congénita (CEC), Instituto de Investigación Biomédica de A Coruña (INIBIC), A Coruña, España.
authors.forename: Francisco
authors.initials: F
authors.lastname: Portela-Torron
authors.affiliation: Servicio de Cirugía Cardiaca, Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas, A Coruña, España; Cardiopatía Estructural y Congénita (CEC), Instituto de Investigación Biomédica de A Coruña (INIBIC), A Coruña, España.
authors.forename: Victor
authors.initials: V
authors.lastname: Bautista-Hernandez
mesh_terms: D006348:Cardiac Surgical Procedures / Q000379:methods; D015331:Cohort Studies; D004374:Ductus Arteriosus, Patent / Q000601:surgery*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Cardiac surgical procedures; Cirugía cardiaca; Ductus arterioso persistente; Patent ductus arteriosus; Premature infant; Prematuro