Document Detail


Tranexamic acid reduces blood loss during percutaneous nephrolithotomy: a prospective randomized controlled study.
MedLine Citation:
PMID:  23123376     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Bleeding is a significant morbidity associated with percutaneous nephrolithotomy. This study was conducted to evaluate the safety and efficacy of the antifibrinolytic agent tranexamic acid in reducing blood loss in patients undergoing percutaneous nephrolithotomy.
MATERIALS AND METHODS: A total of 200 patients undergoing percutaneous nephrolithotomy were randomized into 2 equal groups. Patients in the tranexamic acid group received 1 gm tranexamic acid at induction followed by 3 oral doses of 500 mg during 24 hours, while those in the control group did not receive tranexamic acid. The patient demographics and clinical data of the 2 groups were compared.
RESULTS: Baseline patient demographics were similar in both groups. Mean hemoglobin decrease in the tranexamic acid group was significantly lower than that of the control group (1.39 vs 2.31 gm/dl, p <0.0001). Mean operative time in the tranexamic acid group was significantly lower than that in the control group (48.3 vs 70.8 minutes, p <0.0001). The stone clearance rate was similar in both groups (91% vs 82%, p = 0.06). The blood transfusion rate was lower in the tranexamic acid group (2% vs 11%, p = 0.018), as was the complication rate (33% vs 59%, p <0.0001). Two patients with a solitary functioning kidney in the tranexamic acid group required ureteral stenting to relieve anuria due to clot obstruction.
CONCLUSIONS: The use of tranexamic acid in percutaneous nephrolithotomy is safe, and is associated with reduced blood loss and a lower complication rate.
Authors:
Santosh Kumar; Muninder Singh Randhawa; Raguram Ganesamoni; Shrawan K Singh
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2012-10-30
Journal Detail:
Title:  The Journal of urology     Volume:  189     ISSN:  1527-3792     ISO Abbreviation:  J. Urol.     Publication Date:  2013 May 
Date Detail:
Created Date:  2013-04-18     Completed Date:  2013-06-17     Revised Date:  2014-01-07    
Medline Journal Info:
Nlm Unique ID:  0376374     Medline TA:  J Urol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1757-61     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Adult
Antifibrinolytic Agents / therapeutic use*
Blood Loss, Surgical / prevention & control*
Female
Humans
Male
Nephrostomy, Percutaneous*
Prospective Studies
Single-Blind Method
Tranexamic Acid / therapeutic use*
Chemical
Reg. No./Substance:
0/Antifibrinolytic Agents; 6T84R30KC1/Tranexamic Acid
Comments/Corrections
Comment In:
Aktuelle Urol. 2013 Nov;44(6):428-9   [PMID:  24281930 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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