Perioperative Parenteral Tranexamic Acid in Liver Tumor Resection

Wu, Chien-Hung; Ho, William L.; Cheng, Shao-Bin; Yeh, Dah-Cherng; Wen, Mei‐Chin; Liu, Tse‐Jia; P’eng, Fang-Ku

doi:10.1097/01.sla.0000197561.70972.73

Cited by 120 publications

(30 citation statements)

References 39 publications

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“…The incidence of significant bleeding in patients included in this study was lower than that for recent series in the literature. 13,19–21 Lesions adjacent to or invading large hepatic veins are recognized to be at increased risk of bleeding. 22 The major risk factors for significant or uncontrolled bleeding are the size and location of the lesion.…”

Section: Discussionmentioning

confidence: 99%

Complications of Liver Resection: Laparoscopic Versus Open Procedures

Slakey¹,

Simms²,

Drew³

et al. 2013

JSLS

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Section: Discussionmentioning

confidence: 99%

Complications of Liver Resection: Laparoscopic Versus Open Procedures

Slakey¹,

Simms²,

Drew³

et al. 2013

JSLS

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“…24 In a randomised controlled trial investigating the effectiveness of tranexamic acid in hepatectomy patients, Wu et al reported that patients in the tranexamic acid group experienced significantly lower overall levels of perioperative blood loss when compared with a placebo group (300 mL versus 600 mL, p < 0.001). 25 Blood transfusion is another strategy which can be used to address anaemia during the perioperative period. However, this approach should be carefully considered as large cohort studies have reported a 29-32% higher risk of PM in surgical patients who receive perioperative transfusions.…”

Section: Discussionmentioning

confidence: 99%

Preoperative anaemia in patients undergoing open intra-abdominal surgery at a South African tertiary hospital

Jadhunandan

Moodley

Gopalan

2020

Southern African Journal of Anaesthesia and Analgesia

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Background: The prevalence of preoperative anaemia (PA) in mixed surgical populations is as high as 47.8%. PA in mixed surgical populations is associated with increased postoperative mortality (PM). It is likely that the prevalence of PA and the associated risk of PM might be higher in open intra-abdominal surgery (OIAS) populations, such as laparotomy patients, due to the underlying disease pathologies in this group. An investigation of PA in OIAS patients can inform future improvements in the perioperative management of this high-risk surgical group. Method: This was a sub-analysis of data from a pre-existing registry of 435 laparotomy patients who attended a South African tertiary hospital. The registry collected data on preoperative haemoglobin (Hb), patient characteristics, and PM. Identified PA was graded according to World Health Organization definitions. Established mean red cell volume (MCV) thresholds were used for the morphological classification of PA. Results: The prevalence of PA was 71.0% (95% confidence interval [CI]: 66.8–75.3%). Overall, PA was associated with a three-fold higher risk of PM (odds ratio 3.35, p < 0.001). Postoperative mortality was higher in patients with moderate and severe anaemia than in those without anaemia, while there was no difference in PM between patients with mild anaemia and non-anaemic patients. Conclusion: PA is common in OIAS patients and is associated with increased PM. Identification of OIAS patients with PA, and appropriate preoperative management of these patients is recommended.

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“…So some authors propose the utilization of drugs with antifibrinolytic effect like Aprotinin that is reported to be capable of reducing intraoperative blood loss (especially during liver resection time) and transfusions [117–119]. Other authors propose utilization of the cheaper Tranexamic acid reporting similar results [120]. Although a theoretical risk of thromboembolic complications is present, no adverse drug effects like deep venous thrombosis, pulmonary embolism, or other circulatory disturbances were detected in both these studies.…”

Section: How Can We Reduce Bleeding In Liver Surgery?mentioning

confidence: 99%

Bleeding in Hepatic Surgery: Sorting through Methods to Prevent It

et al. 2012

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Liver resections are demanding operations which can have life threatening complications although they are performed by experienced liver surgeons. The parameter “Blood Loss” has a central role in liver surgery, and different strategies to minimize it are a key to improve results. Moreover, recently, new technologies are applied in the field of liver surgery, having one goal: safer and easier liver operations. The aim of this paper is to review the different principal solutions to the problem of blood loss in hepatic surgery, focusing on technical aspects of new devices.

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Perioperative Parenteral Tranexamic Acid in Liver Tumor Resection

Abstract: Perioperative parenteral use of TA reduced the amount of operative blood loss and the need for blood transfusion in elective liver tumor resection. A real "blood transfusion"-free hepatectomy may be feasible with the assistance of parenteral TA.

Cited by 120 publications

References 39 publications

Complications of Liver Resection: Laparoscopic Versus Open Procedures

Complications of Liver Resection: Laparoscopic Versus Open Procedures

Preoperative anaemia in patients undergoing open intra-abdominal surgery at a South African tertiary hospital

Bleeding in Hepatic Surgery: Sorting through Methods to Prevent It

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