The role of antifibrinolytic agents in gynecologic cancer surgery

Çelebi, Nalan; Çelebioğlu, Bilge; Selçuk, Mehmet Timur; Canbay, Özgür; Karagöz, Ayşe Heves; Aypar, Ülkü

doi:10.1097/00003643-200505001-00288

Cited by 22 publications

(43 citation statements)

References 20 publications

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“…Only a few of the previously published randomized trials of tranexamic acid deal with cancer surgery (breast and prostate cancer) and none have been performed in gynecological oncology surgery . In a retrospective study from Turkey , tranexamic acid was found to reduce the amount of perioperative bleeding by 30% in women undergoing surgery for gynecological malignancies. Our study confirms the effect of tranexamic acid in reducing blood loss and transfusion rate.…”

Section: Discussionmentioning

confidence: 99%

“…Within gynecological cancer surgery, data are scarce on the effect of tranexamic acid on blood loss and blood transfusion requirements and it is of great interest to analyze whether a similar positive effect on bleeding volume and transfusion rate can be achieved in gynecological surgery. We conducted a randomized double‐blinded placebo‐controlled multicenter study with the primary objective of determining whether a single dose of tranexamic acid given intravenously immediately preoperatively in abdominal surgery for presumed advanced ovarian cancer can reduce perioperative blood loss and as secondary objective reduce the need for blood transfusion.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Single‐dose tranexamic acid in advanced ovarian cancer surgery reduces blood loss and transfusions: double‐blind placebo‐controlled randomized multicenter study

Lundin

Johansson

Zachrisson

et al. 2014

Acta Obstet Gynecol Scand

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Single‐dose tranexamic acid in advanced ovarian cancer surgery reduces blood loss and transfusions: double‐blind placebo‐controlled randomized multicenter study

Lundin

Johansson

Zachrisson

et al. 2014

Acta Obstet Gynecol Scand

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“…From this study, it seems that nephrostomy tube increased the length of hospitalisation. Few reports in literature observed the occurrence of thromboembolic events associated with the use of tranexamic acid like deep vein thrombosis, pulmonary embolism or myocardial infarction and ureteral obstruction due to clot formation in patients with upper urinary tract bleeding [9][10][11][12] . Fortunately, none of the patients reviewed in this study had experienced any complications related to tranexamic acid.…”

Section: Discussionmentioning

confidence: 99%

Does Intra-Operative Administration of Tranexamic Acid Increases the Chance of Tubeless Percutaneous Nephrolithotomy

Jhanwar¹,

Jain²,

Lashkary³

et al. 2016

IJMRP

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Objective: To observe the outcome of intra-operative administration of tranexamic acid (TXA) in percutaneous nephrolithotomy (PCNL). Patients and Methods: We retrospectively review the records of 198 patients from August 2014 to April 2016. Patients were divided into two groups on the basis of tranexamic acid. Group A (n=96) were given intra operative tranexamic acid and group B (n=102) did not receive any tranexamic acid. Results: The mean age in group A was 34.28 ± 10.38 and in group B was 34.9 ± 10.76 years (p=0.772), mean stone size in group A and B were 1.97± 0.52, 2.01± 2.40 cms respectively, p=0.912).The mean operative time in group A and B were 44±4.2, 52.55 ±16 minutes respectively, p=0.0001), mean hemoglobin (g/dl) change was 0.98 ±0.26 and 1.6±0.42 in group A and B respectively (p=0.001). Mean hospital stay was 69.61± 11.5 and 78.2±10.6 hours in group A and B respectively (p=0.0002). Twelve patients (12.5%) in group A and 93 (91.1%) patients in group B had nephrostomy tube placement (p=0.0001). Conclusions: Intraoperative administration of tranexamic acid increases the chances of tubeless percutaneous nephrolithotomy.

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“…The direct cost of one unit of Red Blood Cells (RBC) is about SEK 1,500, which is expensive compared to the cost of a single dose of 1.5 gram tranexamic acid for intravenous use, which is about SEK 100. Within gynaecological cancer surgery data are scarce on the preventive effect of tranexamic acid on blood loss and blood transfusion requirements (Celebi, et al 2006). It is clinically interesting to analyse whether a similar positive effect as seen in other surgical areas can be achieved in cytoreductive surgery for advanced ovarian cancer and whether this could improve the care of women with ovarian cancer.…”

Section: Tranexamic Acid (Cyklokapron®)mentioning

confidence: 99%

On Quality Improvement in Gynaecological Cancer Surgery

Lundin

2020

Linköping University Medical Dissertations

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Objectives: The overall purpose of this thesis was to find medical and surgical treatment methods of improving the perioperative care of gynaecological cancer patients. The specific objectives were to determine whether a single dose tranexamic acid given immediately before surgery for presumed advanced ovarian cancer reduces perioperative blood loss and the need for blood transfusions, and to determine whether postoperative recovery, tissue damage, and inflammatory response markers differ between women operated with robotic and abdominal hysterectomy for low-risk endometrial cancer in an enhanced recovery after surgery (ERAS) programme, and to evaluate costs for hospital stay and postoperative recovery in relation to health impact. Material and Methods: The thesis was based on two randomised trials. The first trial was a randomised double-blind placebo-controlled multicentre study conducted in four hospitals in the southeast and central of Sweden between March 2008 and May 2012. One hundred women with presumed advanced ovarian cancer who had been scheduled for radical debulking surgery were included; 50 received tranexamic acid and 50 received a placebo. The main outcomes were blood loss and red blood cell transfusions. The second trial was a randomised open single centre trial at a Swedish university hospital, which included 50 women with low-risk endometrial cancer scheduled for radical surgery between February 2012 and May 2016; 25 women underwent robotic hysterectomy and 25 had abdominal hysterectomy. Anaesthesia and perioperative care followed an ERAS protocol in both groups. The EuroQol Group form EQ-5D-3L and the Short Form-36 evaluated the health-related quality of life. The Swedish Postoperative Symptoms Questionnaire assessed symptoms perioperatively until six weeks postoperatively. Venous blood samples were collected on several occasions until six weeks postoperatively and were analysed for markers reflecting inflammatory response and tissue damage. In addition, a health-economy analysis was conducted comparing total costs, quality-adjusted life years (QALYs) and cost per QALY between the surgical methods. Results: Total blood loss volume and transfusion rate following surgery in advanced ovarian cancer were significantly lower in the tranexamic group compared with the placebo group. Women with early endometrial cancer treated by robotic hysterectomy recovered significantly faster in the EQ-5D health index, and reached their preoperative level nearly two weeks earlier than the abdominal group. Differences regarding improvement in health-related quality of life (Short Form-36) comprising general health and social functioning were more favourable in the robotic hysterectomy group. Consumption of analgesics, pain intensity, postoperative symptom sum score and length of hospital stay were equal between the groups. The occurrence of complications was an independent risk factor and influenced most of the outcome measures adversely. Postoperative inflammatory response and tissue damage were lower after roboti...

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The role of antifibrinolytic agents in gynecologic cancer surgery

Abstract: To compare the effects of crystalloid and colloid solutions, tranexamic acid and epsilon-aminocaproic acid on the need for allogenic blood transfusion and on coagulation and fibrinolysis parameters.

Cited by 22 publications

References 20 publications

Single‐dose tranexamic acid in advanced ovarian cancer surgery reduces blood loss and transfusions: double‐blind placebo‐controlled randomized multicenter study

Single‐dose tranexamic acid in advanced ovarian cancer surgery reduces blood loss and transfusions: double‐blind placebo‐controlled randomized multicenter study

Does Intra-Operative Administration of Tranexamic Acid Increases the Chance of Tubeless Percutaneous Nephrolithotomy

On Quality Improvement in Gynaecological Cancer Surgery

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