Tranexamic acid effects in postoperative bleeding outcomes in laparoscopic sleeve gastrectomy: a controlled study

Brito, Roger Moura de; Oliveira, Clair Motos de; Moura, Ed Carlos Rey; Campelo, Giuliano Peixoto; Lima, Roclides Castro de; Fe, Ciro Sousa de Moura; Sousa, Tercio Maia; Oliveira, Eduardo José Silva Gomes de; Dibai‐Filho, Almir Vieira; Leal, Plínio da Cunha

doi:10.1590/acb370702

Cited by 8 publications

(13 citation statements)

References 28 publications

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“…Blood loss (ml): Three studies with a total of 229 patients [ 18 , 21 , 29 ] showed that the group administered TXA had a significantly lower volume of lost blood intraoperatively compared to the control group (MD= -39.64, 95%CI [-75.49, -3.78], P=0.03). Considerable heterogeneity was found and could not be resolved (I2=94%) (Figure 4 ).…”

Section: Reviewmentioning

confidence: 99%

“…Operative time (minutes): Five studies with substantial heterogeneity provided data from 644 patients [ 18 , 21 , 22 , 28 , 29 ] that revealed significantly shorter operative time in the TXA group compared to the control group (MD= -5.84, 95%CI [-9.62, -2.05], P=0.003, I2=73%) (Figure 5 ).…”

Section: Reviewmentioning

confidence: 99%

“…Length of hospital stay (days): Analysis of three homogenous studies enrolling 476 patients [ 22 , 28 , 29 ] showed a significantly shorter hospital stay associated with the TXA group compared to the control group (MD=-0.24, 95%CI [-0.32, -0.17], P< 0.00001, I2 =0%) (Figure 8 ).…”

Section: Reviewmentioning

confidence: 99%

“…Mocanu and colleagues conducted a recent meta-analysis comprising data from 475 patients [ 19 ] who were enrolled in four moderate to low-quality studies [ 18 , 20 , 28 , 29 ] and underwent laparoscopic sleeve gastrectomy (LSG). They found TXA significantly associated with the reduction of postoperative bleeding by 60% compared to the placebo group (OR= 0.40; 95% CI [ 0.23-0.70]; P= 0.001).…”

Section: Reviewmentioning

confidence: 99%

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The Role of Tranexamic Acid in Sleeve Gastrectomy: A Systematic Review and Meta-Analysis

Al-Juhani,

Sharaf,

Aseri

et al. 2024

Cureus

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Tranexamic acid (TXA) is an essential procoagulant drug used in various intra- and postoperative situations. Its efficacy and safety profile in obese cases undergoing laparoscopic sleeve gastrectomy (LSG) is still unresolved. Therefore, this meta-analysis evaluated and investigated the current intra- and postoperative effects and hazards of TXA on patients undergoing LSG. As for methodology, Web of Science, Cochrane Library, Scopus, and PubMed were thoroughly searched for relevant studies. Retrieved results were prepared for screening through Endnote, helping to identify eligible studies. Relevant patient characteristics and outcomes were extracted. The methodological quality of the relevant studies was appraised using the respected appraisal tool. Six studies of different designs were enrolled, comprising 753 cases that underwent LSG and administered TXA. Their mean BMI and age went from 37.3 to 56.25 kg/m 2 and 33.5 to 43.25 years, respectively. Tranexamic acid significantly linked to reduction in intraoperative bleeding instances, operative blood loss, and operative duration, compared to placebo ((RR = 0.66, 95% CI [0.44, 0.98], P=0.04, I 2 = 81%); (MD = -39.64, 95%CI [-75.49, -3.78], P=0.03, I 2 =94%); (MD=-5.84, 95%CI [-9.62, -2.05], P=0.003, I 2 =73%)). Tranexamic acid also significantly showed superiority regarding postoperative bleeding events and duration of hospitalization compared to the control group ((RR= 0.45, 95%CI [0.29, 0.69], P=0.0002, I 2 =0%); (MD=-0.24, 95%CI [-0.32, -0.17], P< 0.0000, I 2 =0%)). Moreover, follow-up of the enrolled patients for a minimum of three to six months resulted in no reported thromboembolic instances, suggesting a negligible risk for thromboembolism among patients undergoing LSG and receiving TXA. In conclusion, tranexamic acid demonstrates a robust safety and efficacy profile for its use in patients undergoing LSG, with no reported instances of thromboembolism. Variations in TXA administration regimens, bleeding definitions, procedural techniques, and potential confounding medications could not be accounted for, necessitating additional large-scale RCTs to address and bridge knowledge gaps.

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Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

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The Role of Tranexamic Acid in Sleeve Gastrectomy: A Systematic Review and Meta-Analysis

Al-Juhani,

Sharaf,

Aseri

et al. 2024

Cureus

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“…In metabolic surgery, around 2%-4% of patients experience bleeding, with 3% requiring reoperation (32). Tranexamic acid has been reported to reduce the incidence of bleeding, surgery duration, hospital length of stay, without increasing thromboembolic events (32)(33)(34). A metaanalysis suggested that a dose of 1 g of TXA given at anesthetic induction might be as effective as higher doses (35).…”

Section: Minimizing Blood Lossmentioning

confidence: 99%

A patient blood management perspective on Anemia in the obese patient journey

Duarte¹,

Wei

Cho³

2023

Front. Anesthesiol.

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Obesity and anemia are increasing prevalence around the globe. They can interplay and are both associated with high morbidity and poorer clinical outcomes. Inflammation and iron deficiency are important contributors to anemia in obese patients. Furthermore, obesity surgery can trigger high blood loss, increased demand for blood transfusions and long-term nutrient deficiency. Patient blood management programs have been crucial in improving patients' clinical results whilst minimizing costs in many different settings, such as orthopedic surgery, cardiovascular surgery, pregnancy and intensive care unit patients. In this mini-review, we will discuss applications of patient blood management principles in caring of obese individuals during the patient journey.

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Role of Tranexamic Acid (TXA) in Preventing Bleeding Following Sleeve Gastrectomy: a Systematic Review and Meta-analysis

et al. 2023

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Tranexamic acid effects in postoperative bleeding outcomes in laparoscopic sleeve gastrectomy: a controlled study

Cited by 8 publications

References 28 publications

The Role of Tranexamic Acid in Sleeve Gastrectomy: A Systematic Review and Meta-Analysis

The Role of Tranexamic Acid in Sleeve Gastrectomy: A Systematic Review and Meta-Analysis

A patient blood management perspective on Anemia in the obese patient journey

Role of Tranexamic Acid (TXA) in Preventing Bleeding Following Sleeve Gastrectomy: a Systematic Review and Meta-analysis

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