Can high-dose tranexamic acid have a role during transurethral resection of the prostate in large prostates? A randomised controlled trial

Samir, Mohamed; Saafan, Ahmed; Afifi, Rania M; Tawfick, Ahmed

doi:10.1080/2090598x.2021.1932125

Cited by 10 publications

(21 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For example, TXA seems to decrease surgical time during TURP. 38 , 39 This advantage is desirable to decrease the potential complications, like thromboembolism events, blood loss, and effects due to irrigating fluid absorption, especially in oncological patients.…”

Section: Clinical Usage and Efficacy Of Tranexamic Acid In Oncologic ...mentioning

confidence: 99%

Efficacy and Safety of Tranexamic Acid in Cancer Surgery. An Update of Clinical Findings and Ongoing Research

Zec¹,

Napoli²,

Fiévez³

et al. 2022

JMDH

View full text Add to dashboard Cite

In cancer patients undergoing surgery, tumor biology and anticancer treatments can increase the risk of perioperative bleeding and blood transfusions. Notably, blood transfusions can be potentially associated with an increased risk of life-threatening immune responses, acute lung injury, postoperative infections, and thromboembolism. Moreover, the link between perioperative transfusion and increased risk of cancer recurrence cannot be excluded. On the other hand, cancer patients have an increased risk of thromboembolism due to cancer itself and antineoplastic systemic treatments including chemotherapy and anti-angiogenic drugs. In this complex scenario, effective and safe strategies aimed at the prevention of blood transfusions are warranted. This narrative review addresses the efficacy, and the safety of the synthetic antifibrinolytic agent tranexamic acid (TXA) when used perioperatively in cancer surgery. Although in not oncologic surgery the use of TXA has been extensively studied, in the setting of cancer patients requiring surgery, the evidence is scarce. An overview of the ongoing clinical research is also provided.

show abstract

Section: Clinical Usage and Efficacy Of Tranexamic Acid In Oncologic ...mentioning

confidence: 99%

Efficacy and Safety of Tranexamic Acid in Cancer Surgery. An Update of Clinical Findings and Ongoing Research

Zec¹,

Napoli²,

Fiévez³

et al. 2022

JMDH

View full text Add to dashboard Cite

show abstract

“…Also, the mean operative time of the TXA group was significantly lower compared to placebo (68.45 vs. 87.62 min, P < 0.001) [ 10 ]. Also, Samir et al [ 17 ] reported that high-dose TXA was effective in controlling blood loss during bipolar TURP in patients with large prostates. However, no study has been conducted on the use of TXA in the irrigation fluid during TURP.…”

Section: Discussionmentioning

confidence: 99%

Can tranexamic acid in irrigation fluid reduce blood loss during monopolar transurethral resection of the prostate? A randomised controlled trial

Tawfick

Mousa

El-Zhary

et al. 2022

Arab Journal of Urology

Self Cite

View full text Add to dashboard Cite

Objective To assess the efficacity and safety of using tranexamic acid (TXA) in the irrigation solution during transurethral resection of the prostate (TURP). Patients and Methods A total of 50 patients undergoing TURP for benign prostatic hyperplasia were prospectively randomised in a controlled clinical trial and distributed into two groups. Group A received 0.1% TXA 1000 mg (10 mL) in 1 L of irrigation solution of sterile wash (glycine) during surgery, while Group B received 10 mL distilled water (placebo) in 1 L of irrigation solution of sterile wash (glycine) during surgery. At the end of surgery, a three-way catheter was inserted in the bladder. Group A received local 500 mg of TXA (5 mL), which was dissolved in 100 mL of normal saline solution, while Group B received distilled water (5 mL) dissolved in 100 mL of normal saline solution after which the catheter was clamped. The serum haemoglobin (Hb) concentration, haematocrit (HCT), blood loss volume, Hb concentration in the irrigation fluid, and bladder irrigation volumes were compared between the two groups at three time-points: preoperatively and at 4- and 24-h postoperatively. Coagulation function, complications, thromboembolic events, quality of endoscopic view, surgery duration, and hospital stay were also noted. Results Group A had significantly lower blood loss intraoperatively, and at 4- and 24-h postoperatively compared to the control group ( P < 0.05). The serum Hb concentration, HCT, Hb concentration in the irrigation fluid, and bladder irrigation volumes were significantly lower in the TXA group vs the control group ( P < 0.001). The shortening of the surgery duration and improvement in the quality of the endoscopic view were significantly noted in the TXA group ( P = 0.001). However, no thromboembolic events occurred in either group. Conclusion The use of TXA in the irrigation fluid during TURP and injection into the bladder postoperatively can reduce blood loss and the need for blood transfusion without increasing the risk of thrombosis.

show abstract

“…Finally, this meta-analysis included 13 RCTs. [7][8][9][10][11][12][13][14][15][16][17][18][19] One trial included patients from 2 hospitals, and the other 12 trials were all conducted in a single hospital. Seven trials targeted patients undergoing percutaneous nephrolithotomy, [8,[12][13][14][15]17,18] 5 focused on prostatectomy, [7,9,10,16,19] and 1 investigated transurethral resection of the prostate/bladder tumor.…”

Section: Characteristics Of Enrolled Trialsmentioning

confidence: 99%

“…[7][8][9][10][11][12][13][14][15][16][17][18][19] One trial included patients from 2 hospitals, and the other 12 trials were all conducted in a single hospital. Seven trials targeted patients undergoing percutaneous nephrolithotomy, [8,[12][13][14][15]17,18] 5 focused on prostatectomy, [7,9,10,16,19] and 1 investigated transurethral resection of the prostate/bladder tumor. [11] In all 13 trials, TXA was administered before surgery, and patients in 8 trials also received postoperative TXA.…”

Section: Characteristics Of Enrolled Trialsmentioning

confidence: 99%

See 1 more Smart Citation

Efficacy and safety of intravenous tranexamic acid in urologic surgery: A systematic review and meta-analysis of randomized controlled trials

et al. 2023

View full text Add to dashboard Cite

Background: This meta-analysis compared the effects of intravenous Tranexamic acid (TXA) and a placebo on hemostasis, hospital course, and complications in adult patients undergoing various urologic surgeries.Methods: The literature was extensively searched using various databases. The primary outcomes were standardized mean differences (SMDs) of intraoperative blood loss and odds ratios (ORs) of necessary blood product transfusion. The secondary outcomes included SMDs of operative time, SMDs of decreased hemoglobulin levels at 24 hours after surgery, and ORs of thromboembolic events.Results: The meta-analysis included 13 randomized controlled trials (RCT) comprising 1814 participants in total. The SMD of intraoperative blood loss for TXA versus placebo was −0.705 (95% confidence interval [CI]: −1.113 to −0.297). The pooled ORs of transfusion in the TXA group compared with the placebo group was 0.426 (95% CI: 0.290-0.625). These findings indicated a significantly lower intraoperative blood loss and a reduced need for transfusion following intravenous TXA. The pooled ORs of thromboembolic events in the TXA group compared with the placebo group was 0.664 (95% CI: 0.146-3.024).Conclusions: Intravenous TXA can reduce intraoperative blood loss, decrease the need for transfusion, and shorten operative time, and it does not increase the risk of thromboembolic events.

show abstract

Can high-dose tranexamic acid have a role during transurethral resection of the prostate in large prostates? A randomised controlled trial

Abstract: Can high-dose tranexamic acid have a role during transurethral resection of the prostate in large prostates? A randomised controlled trial, Arab Journal of Urology,

Cited by 10 publications

References 30 publications

Efficacy and Safety of Tranexamic Acid in Cancer Surgery. An Update of Clinical Findings and Ongoing Research

Efficacy and Safety of Tranexamic Acid in Cancer Surgery. An Update of Clinical Findings and Ongoing Research

Can tranexamic acid in irrigation fluid reduce blood loss during monopolar transurethral resection of the prostate? A randomised controlled trial

Efficacy and safety of intravenous tranexamic acid in urologic surgery: A systematic review and meta-analysis of randomized controlled trials

Contact Info

Product

Resources

About