Paweł Lech1, Maciej Michalik2, Kamil Waczyński1, Karolina Osowiecka3, Natalia Dowgiałło-Gornowicz4. 1. Department of General, Minimally Invasive and Elderly Surgery, Collegium Medicum, University of Warmia and Mazury, Niepodległości 44 St, 10-045, Olsztyn, Poland. 2. Department of General, Colorectal and Oncologic Surgery, Collegium Medicum, Nicolaus Copernicus University in Torun, Ujejskiego 75 St, 85-168, Bydgoszcz, Poland. 3. Department of Psychology and Sociology of Health and Public Health, School of Public Health, University of Warmia and Mazury, Warszawska 30 St, 10-041, Olsztyn, Poland. 4. Department of General, Minimally Invasive and Elderly Surgery, Collegium Medicum, University of Warmia and Mazury, Niepodległości 44 St, 10-045, Olsztyn, Poland. natalia.dowgiallo@gmail.com.
Abstract
PURPOSE: Laparoscopic sleeve gastrectomy (LSG) is currently the most common bariatric surgery in the world. Although it appears to be a safe treatment for obesity, it is still at risk of complications. The latest literature shows that postoperative bleeding occurs in 2-4% of cases, and up to 3% of cases requires reoperation for hemostasis. The aim of the study is to assess the effect of tranexamic acid (TXA) on hemorrhagic events and the reoperation rate in patients undergoing LSG. METHODS: The study was designed as a retrospective analysis of patients undergoing LSG. We investigate the patients 6 months before and 6 months after introducing the prophylaxis doses of TXA into our bariatric protocol (non-TXA group vs TXA group). RESULTS: Three hundred fourteen patients underwent LSG in a high-volume center from 2016 to 2017. After introducing TXA, a statistically significant reduction in the incidence of hemorrhage during surgery was observed (22.3% vs 10.8%, p = 0.006). There was a statistically significant reduction in the need for the staple line oversewing (10.2% vs 1.9%, p = 0.002). The mean operating time and the mean length of hospital stay were significantly higher in the non-TXA group than TXA group (63.1 vs 53.7 min, p < 000.1; 2.3 vs 2.1, p = 0.02). In both groups of patients, no venous thromboembolism or other complications occurred within 6 months after the surgery. CONCLUSIONS: The prophylactic doses of TXA may be useful in reducing the hemorrhagic events during LSG. It may also shorten the length of hospital stay and the operating time.
PURPOSE: Laparoscopic sleeve gastrectomy (LSG) is currently the most common bariatric surgery in the world. Although it appears to be a safe treatment for obesity, it is still at risk of complications. The latest literature shows that postoperative bleeding occurs in 2-4% of cases, and up to 3% of cases requires reoperation for hemostasis. The aim of the study is to assess the effect of tranexamic acid (TXA) on hemorrhagic events and the reoperation rate in patients undergoing LSG. METHODS: The study was designed as a retrospective analysis of patients undergoing LSG. We investigate the patients 6 months before and 6 months after introducing the prophylaxis doses of TXA into our bariatric protocol (non-TXA group vs TXA group). RESULTS: Three hundred fourteen patients underwent LSG in a high-volume center from 2016 to 2017. After introducing TXA, a statistically significant reduction in the incidence of hemorrhage during surgery was observed (22.3% vs 10.8%, p = 0.006). There was a statistically significant reduction in the need for the staple line oversewing (10.2% vs 1.9%, p = 0.002). The mean operating time and the mean length of hospital stay were significantly higher in the non-TXA group than TXA group (63.1 vs 53.7 min, p < 000.1; 2.3 vs 2.1, p = 0.02). In both groups of patients, no venous thromboembolism or other complications occurred within 6 months after the surgery. CONCLUSIONS: The prophylactic doses of TXA may be useful in reducing the hemorrhagic events during LSG. It may also shorten the length of hospital stay and the operating time.
Authors: Richard Welbourn; Marianne Hollyman; Robin Kinsman; John Dixon; Ronald Liem; Johan Ottosson; Almino Ramos; Villy Våge; Salman Al-Sabah; Wendy Brown; Ricardo Cohen; Peter Walton; Jacques Himpens Journal: Obes Surg Date: 2018-11-12 Impact factor: 4.129
Authors: Piotr Małczak; Magdalena Pisarska; Major Piotr; Michał Wysocki; Andrzej Budzyński; Michał Pędziwiatr Journal: Obes Surg Date: 2017-01 Impact factor: 4.129