Evidence map›Paper›PMID 41415534›Full record

ArticleFrontiers in surgery2025

Veterinary and technical optimization of the fetal sheep model of congenital diaphragmatic hernia: implications for translational pediatric surgery.

T Connor McCorkell, Daniela Espinosa Seoane, Elke Zani-Ruttenstock, Fabian Doktor, Rebeca Figueira, Melissa Sinclair, Alex Zur Linden, Marta Horna, Lucciana Recchi, Alice Defarges and 4 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Frontiers in surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

T Connor McCorkellDepartment of Clinical Studies, Ontario Veterinary College, The University of Guelph, Guelph, ON, Canada.
Daniela Espinosa SeoaneDepartment of Clinical Studies, Ontario Veterinary College, The University of Guelph, Guelph, ON, Canada.
Elke Zani-RuttenstockDivision of Pediatric Surgery, Children's Hospital, LHSC, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.
Fabian DoktorDivision of Pediatric Surgery, Hospital for Sick Children, The University of Toronto, Toronto, ON, Canada.
Rebeca FigueiraDivision of Pediatric Surgery, Hospital for Sick Children, The University of Toronto, Toronto, ON, Canada.
Melissa SinclairDepartment of Clinical Studies, Ontario Veterinary College, The University of Guelph, Guelph, ON, Canada.
Alex Zur LindenDepartment of Clinical Studies, Ontario Veterinary College, The University of Guelph, Guelph, ON, Canada.
Marta HornaDepartment of Clinical Studies, Ontario Veterinary College, The University of Guelph, Guelph, ON, Canada.
Lucciana RecchiDepartment of Clinical Studies, Ontario Veterinary College, The University of Guelph, Guelph, ON, Canada.
Alice DefargesDepartment of Clinical Studies, Ontario Veterinary College, The University of Guelph, Guelph, ON, Canada.
Lina AntouniansDivision of Pediatric Surgery, Hospital for Sick Children, The University of Toronto, Toronto, ON, Canada.
Andreana BütterDivision of Pediatric Surgery, Children's Hospital, LHSC, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.
Augusto ZaniDivision of Pediatric Surgery, Hospital for Sick Children, The University of Toronto, Toronto, ON, Canada.
Judith KoenigDepartment of Clinical Studies, Ontario Veterinary College, The University of Guelph, Guelph, ON, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Congenital diaphragmatic hernia (CDH) is a life-threatening developmental anomaly where abdominal organs herniate into the thoracic cavity, impairing fetal lung growth and subsequent postnatal lung function. Despite advances in treatment, the morbidity and mortality of CDH remain significant. Currently, the most well-established fetal intervention is fetoscopic endoluminal tracheal occlusion (FETO), which promotes lung expansion and development by temporarily blocking the egress of lung fluid. However, treatment outcomes remain variable, which underscores the need for robust animal models to investigate novel therapies. The fetal sheep model is particularly valuable due to physiological similarities to human infants in lung development and anatomy. However, its successful implementation requires substantial veterinary and surgical expertise. In this paper, we outline the surgical protocol, refinements, and perioperative challenges in establishing a fetal sheep model of CDH to test a novel therapy. A diaphragmatic defect was surgically created via fetal thoracotomy at 80 days of gestation using a maternal caudal ventral midline laparotomy. Fetal tracheal occlusion with treatment administration was performed via a maternal left flank laparotomy at 108 days, followed by euthanasia then delivery at 136 days. Initial surgeries experienced complications such as maternal incisional dehiscence and herniation. These were mitigated through changes in surgical approach, closure techniques, and enhanced postoperative care. Veterinary oversight was critical in optimizing maternal well-being, minimizing stress, and improving recovery outcomes. This refined model provides a reproducible, welfare-centred approach integrating essential veterinary contributions to support translational pediatric surgery research in CDH.

Indexed as

congenital diaphragmatic herniafetal surgerylambpediatric surgerypulmonary hypoplasiasheeptranslational animal modelsveterinary medicine

Identifiers

PMID41415534
PMCPMC12708541

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.