PDA surgery and (non-) risk of adverse outcomes

I guess many took impression by data from the TIPP-trial, that suggested that surgical ligation of PDA was associated with increased risks of BPD, ROP and neurosensory impairment. http://www.jpeds.com/article/S0022-3476(06)01108-5/abstract

Data from a recent and relatively large cohort in Canada, where postnatal preligation morbidities where taken closely into account, has now showed that previous research may be explained by confounding by indication. http://jamanetwork.com/journals/jamapediatrics/article-abstract/2606520

In other words, surgical PDA ligation as such may not be associated with adverse outcomes. Nevertheless, I personally believe that PDA surgery is a very invasive procedure and should used only if the clinical scenario is complex and the PDA is considered to have a major role for that scenario.