The Effects of Tranexamic Acid on Bleeding Control During and after Percutaneous Nephrolithotomy (PCNL): A Randomized Clinical Trial
Urology Journal,
Vol. 18 No. 06 (2021),
18 January 2022
,
Page 608-611
https://doi.org/10.22037/uj.v18i06.6505
Abstract
Purpose: Tranexamic acid is a fibrinolysis suppressor that is used for a variety of bleeding control procedures such as hematuria, surgery bleeding, and trauma caused bleeding. The advantages of using the tranexamic acid are bleeding control and less need for blood transfusion.
Materials and Methods: This double blind clinical trial was conducted on 108 patients in Imam Khomeni Hospital, Urmia, Iran 2013-14. The control and intervention groups consisted of 54 randomly selected participants each. The intervention group received 1gr of intravenous tranexamic acid with initiation of surgery and 500mg orally each 8hrs afterwards up to three days. The control group received placebo capsules containing starch of the same form.
Results: The mean term of hospitalization in the intervention group was significantly shorter than that of the control group (P<0.001). The difference between the two groups in terms of preoperative hemoglobin was not significant. However, the decrease in postoperative hemoglobin, intraoperative hemoglobin count in washing liquid, and hemoglobin count in the intervention group were significantly different from those of the control group (P<0.001).
Conclusion: The findings showed that tranexamic acid decreased bleeding during PCNL and the need for blood transfusion. It also decreased the hospitalization term.
- Tranexamic acid, bleeding, percutaneous nephrolithotomy, Iran
How to Cite
References
2. Meng X, Bao J, Mi Q, Fang S. The Analysis of Risk Factors for Hemorrhage Associated with Minimally Invasive Percutaneous Nephrolithotomy. BioMed research international. 2019;2019.
3. Michel MS, Trojan L, Rassweiler JJ. Complications in percutaneous nephrolithotomy. European urology. 2007;51(4):899-906.
4. Rahmani MM AM, Gholami Mahtaj L et al. Comparison of bleeding complication of percutaneous nephrolithotomy in patients with and without previous open nephrolithotomy surgery. Quarterly Journal of Sabzevar University of Medical Sciences. 2013;20(4):556-62.
5. Casati V, Sandrelli L, Speziali G, Calori G, Grasso MA, Spagnolo S. Hemostatic effects of tranexamic acid in elective thoracic aortic surgery: a prospective, randomized, double-blind, placebo-controlled study. The Journal of thoracic and cardiovascular surgery. 2002;123(6):1084-91.
6. Urban D, Dehaeck R, Lorenzetti D, Guilfoyle J, Poon M-C, Steele M, et al. Safety and efficacy of tranexamic acid in bleeding paediatric trauma patients: a systematic review protocol. BMJ open. 2016;6(9):e012947.
7. Huang F, Wu D, Ma G, Yin Z, Wang Q. The use of tranexamic acid to reduce blood loss and transfusion in major orthopedic surgery: a meta-analysis. Journal of Surgical Research. 2014;186(1):318-27.
8. Mohammadi M, Nouri-Mahdavi K, Barzegar A. Effects of Tranexamic Acid on Bleeding and Hemoglobin Levels in Patients with Staghorn Calculi Undergoing Percutaneous Nephrolithotomy: Randomized Controlled Trial. Iranian Journal of Medical Sciences. 2019.
9. Siddiq A, Khalid S, Mithani H, Anis S, Sharif I, Shaikh J. Preventing Excessive Blood Loss During Percutaneous Nephrolithotomy by Using Tranexamic Acid: A Double Blinded Prospective Randomized Controlled Trial. Journal of Urological Surgery. 2017;4(4):195.
10. Mohammadi M, Nouri-Mahdavi K, Barzegar A. Effects of Tranexamic Acid on Bleeding and Hemoglobin Levels in Patients with Staghorn Calculi Undergoing Percutaneous Nephrolithotomy: Randomized Controlled Trial. Iranian journal of medical sciences. 2019;44(6):457-64.
11. Yao Q, Wu M, Zhou J, Zhou M, Chen D, Fu L, et al. Treatment of Persistent Gross Hematuria with Tranexamic Acid in Autosomal Dominant Polycystic Kidney Disease. Kidney & blood pressure research. 2017;42(1):156-64.
12. Cauni V, Mihai V, Barbilian C, Dragutescu M, Buraga I. The use of tranexamic acid for preventing hemorrhagic complications during percutaneous nephrolithotomy. European Urology Supplements. 2017;16(11):e2972.
13. Kumar S, Randhawa MS, Ganesamoni R, Singh SK. Tranexamic acid reduces blood loss during percutaneous nephrolithotomy: a prospective randomized controlled study. The Journal of urology. 2013;189(5):1757-61.
14. El-Nahas AR, Eraky I, Shokeir AA, Shoma AM, El-Assmy AM, El-Tabey NA, et al. Percutaneous nephrolithotomy for treating staghorn stones: 10 years of experience of a tertiary-care centre. Arab journal of urology. 2012;10(3):324-9.
15. Rashid AO, Ahmed HK, Ali DMK. The Use of Tranexamic Acid in Percutaneous Nephrolithotomy. A Randomized Controlled Study (Local Experience). Open Journal of Urology. 2018;8(12):317.
16. Vorrakitpokatorn P, Permtongchuchai K, Raksamani E, Phettongkam A. Perioperative complications and risk factors of percutaneous nephrolithotomy. JOURNAL-MEDICAL ASSOCIATION OF THAILAND. 2006;89(6):826.
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