Meningomyelocele is one of the most common neural tube defects requiring surgical repair in the neonatal period. Postoperative respiratory complications and the need for prolonged mechanical ventilation are important causes of morbidity in these patients. The timing of extubation may influence postoperative respiratory outcomes and the duration of neonatal intensive care unit (NICU) stay. This retrospective cohort study aims to evaluate the impact of operating room extubation on postoperative outcomes in neonates undergoing meningomyelocele repair at Gaziantep City Hospital. Clinical, laboratory, and perioperative data will be obtained from hospital records. Postoperative mechanical ventilation requirement, duration of ventilation, NICU length of stay, and perioperative laboratory changes will be compared between neonates extubated in the operating room and those extubated in the intensive care unit.

Inclusion Criteria:

• Neonates undergoing surgical repair of meningomyelocele
• Surgery performed under general anesthesia
• Age ≤ 28 days at the time of surgery
• Postoperative follow-up in the neonatal intensive care unit (NICU)
• Availability of complete perioperative clinical and laboratory data

Exclusion Criteria:

• Preoperative respiratory distress requiring invasive or non-invasive ventilatory support
• Major congenital anomalies or severe comorbidities (e.g., complex congenital heart disease, severe pulmonary disease, chromosomal abnormalities)
• Neonates with poor postnatal adaptation (5-minute Apgar score < 7)
• Preoperative hemodynamic instability
• Severe prematurity-related respiratory morbidity
• Prolonged mechanical ventilation due to causes unrelated to meningomyelocele surgery
• Incomplete or missing perioperative medical records

Neonates who underwent meningomyelocele repair under general anesthesia at Gaziantep City Hospital between November 2023 and March 2026. All patients were followed postoperatively in the neonatal intensive care unit, and perioperative clinical and laboratory data were obtained from hospital medical records.