Tranexamic acid in laparoscopic sleeve gastrectomy: bleeding control amid thrombotic concerns and hemodynamic instability: a randomized double-blinded clinical trial.
- 1Okan University - Faculty of Medicine - Department of General Surgery - Istanbul - Turkey.
Abstract
Purpose
Laparoscopic sleeve gastrectomy (LSG) carries a risk of intraoperative and postoperative bleeding. Tranexamic acid (TXA) has been proposed to reduce blood loss. We evaluated the efficacy of TXA in preventing perioperative bleeding in patients undergoing LSG.Methods
In a randomized clinical trial, 185 morbidly obese patients scheduled for elective LSG were randomly assigned to receive TXA (n = 93) or a placebo (n = 92) before surgery. The rate of bleeding requiring blood transfusion, 24-hour serum hemoglobin levels, postoperative hemodynamic indices, and the incidence of postoperative thrombotic events were assessed.Results
Intraoperative bleeding occurred less frequently in the TXA group than in the placebo group (1 versus 5.5%, p = 0.012). Postoperative hemoglobin levels were higher in the TXA group (12.5 ± 1.2 g/dL versus 11.1 ± 1.5 g/dL, p = 0.002), while transfusion requirements, hemodynamic stability, and length of hospital stay were similar between groups. No postoperative thromboembolic events were observed. Multivariable analysis confirmed TXA as an independent predictor of reduced bleeding and higher postoperative hemoglobin levels.Conclusion
TXA significantly reduced intraoperative bleeding and improved postoperative hemoglobin levels in LSG without increasing hemodynamic instability or the risk of thromboembolic events.
Related
- Association between anesthetic fresh gas flow and postoperative inflammatory response in laparoscopic sleeve gastrectomy : A retrospective cohort study
- Effects of Laparoscopic Sleeve Gastrectomy on Vascular and Myocardial Recovery: Type 2 Diabetes and Echocardiographic Indices of Diastolic Function
- Baseline adipokine profiles have limited predictive value for weight-loss outcomes after laparoscopic sleeve gastrectomy: a prospective longitudinal cohort study
- Dynamic Changes in Serum Neutrophil Gelatinase-Associated Lipocalin for Discrimination of Creatinine-Defined Acute Kidney Injury After Laparoscopic Sleeve Gastrectomy: A Prospective Observational Cohort Study
- Histopathological findings in laparoscopic sleeve gastrectomy specimens and their relation to preoperative endoscopy : A retrospective cross-sectional study of 954 patients
BibTeX
@article{savas2026tranexamic,
title = {{Tranexamic acid in laparoscopic sleeve gastrectomy: bleeding control amid thrombotic concerns and hemodynamic instability: a randomized double-blinded clinical trial.}},
author = {Osman Anıl Savaş and Selçuk Mercan and Amir Mahdi Akbari and Mehrdad Sheikhvatan},
journal = {Acta cirurgica brasileira},
year = {2026},
month = oct,
doi = {10.1590/acb416226},
url = {https://europepmc.org/article/MED/42912008},
note = {CC BY},
}
RIS
TY - JOUR
TI - Tranexamic acid in laparoscopic sleeve gastrectomy: bleeding control amid thrombotic concerns and hemodynamic instability: a randomized double-blinded clinical trial.
AU - Osman Anıl Savaş
AU - Selçuk Mercan
AU - Amir Mahdi Akbari
AU - Mehrdad Sheikhvatan
PY - 2026
DA - 2026/10/19
JO - Acta cirurgica brasileira
DO - 10.1590/acb416226
UR - https://europepmc.org/article/MED/42912008
AB - Purpose Laparoscopic sleeve gastrectomy (LSG) carries a risk of intraoperative and postoperative bleeding. Tranexamic acid (TXA) has been proposed to reduce blood loss. We evaluated the efficacy of TXA in preventing perioperative bleeding in patients undergoing LSG.Methods In a randomized clinical trial, 185 morbidly obese patients scheduled for elective LSG were randomly assigned to receive TXA (n = 93) or a placebo (n = 92) before surgery. The rate of bleeding requiring blood transfusion, 24-hour serum hemoglobin levels, postoperative hemodynamic indices, and the incidence of postoperative thrombotic events were assessed.Results Intraoperative bleeding occurred less frequently in the TXA group than in the placebo group (1 versus 5.5%, p = 0.012). Postoperative hemoglobin levels were higher in the TXA group (12.5 ± 1.2 g/dL versus 11.1 ± 1.5 g/dL, p = 0.002), while transfusion requirements, hemodynamic stability, and length of hospital stay were similar between groups. No postoperative thromboembolic events were observed. Multivariable analysis confirmed TXA as an independent predictor of reduced bleeding and higher postoperative hemoglobin levels.Conclusion TXA significantly reduced intraoperative bleeding and improved postoperative hemoglobin levels in LSG without increasing hemodynamic instability or the risk of thromboembolic events.
SN - 0102-8650
SN - 1678-2674
ER -