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• W1983728631 abstract "No AccessJournal of UrologyAdult Urology1 May 2013Tranexamic Acid Reduces Blood Loss During Percutaneous Nephrolithotomy: A Prospective Randomized Controlled Study Santosh Kumar, Muninder Singh Randhawa, Raguram Ganesamoni, and Shrawan K. Singh Santosh KumarSantosh Kumar More articles by this author , Muninder Singh RandhawaMuninder Singh Randhawa More articles by this author , Raguram GanesamoniRaguram Ganesamoni More articles by this author , and Shrawan K. SinghShrawan K. Singh More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.10.115AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract 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. References 1 : Chapter 1: AUA guideline on management of staghorn calculi: diagnosis and treatment recommendations. J Urol2005; 173: 1991. Link, Google Scholar 2 : Complications in percutaneous nephrolithotomy. Eur Urol2007; 51: 899. Google Scholar 3 : Noninfectious serious hazards of transfusion. Anesth Analg2009; 108: 759. Google Scholar 4 : Effect of tranexamic acid on surgical bleeding: systematic review and cumulative meta-analysis. BMJ2012; 344: e3054. 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Google Scholar 18 : Aprotinin versus tranexamic acid during liver transplantation: impact on blood product requirements and survival. Transplantation2011; 91: 1273. Google Scholar 19 : The role of antifibrinolytic agents in gynecologic cancer surgery. Saudi Med J2006; 27: 637. Google Scholar 20 : Efficacy of intravenous tranexamic acid in reducing blood loss after elective cesarean section: a prospective, randomized, double-blind, placebo-controlled study. Am J Perinatol2011; 28: 233. Google Scholar 21 : Timing of the administration of tranexamic acid for maximum reduction in blood loss in arthroplasty of the knee. J Bone Joint Surg Br2005; 5: 702. Google Scholar 22 : Tranexamic acid in control of primary hemorrhage during transurethral prostatectomy. Urology2004; 64: 955. Google Scholar 23 : Intraoperative use of tranexamic acid to reduce transfusion rate in patients undergoing radical retropubic prostatectomy: double blind, randomised, placebo controlled trial. BMJ2011; 343: d5701. 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Google Scholar Postgraduate Institute of Medical Education and Research, Chandigarh, India© 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byPerrella R, Vicentini F, Paro E, Torricelli F, Marchini G, Danilovic A, Batagello C, Mota P, Ferreira D, Cohen D, Murta C, Claro J, Giusti G, Monga M, Nahas W, Srougi M and Mazzucchi E (2021) Supine versus Prone Percutaneous Nephrolithotomy for Complex Stones: A Multicenter Randomized Controlled TrialJournal of Urology, VOL. 207, NO. 3, (647-656), Online publication date: 1-Mar-2022.Steers W (2013) This Month in Adult UrologyJournal of Urology, VOL. 189, NO. 5, (1615-1616), Online publication date: 1-May-2013. Volume 189Issue 5May 2013Page: 1757-1761 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.Keywordsnephrostomy, percutaneoushemorrhagenephrolithiasistranexamic acidMetricsAuthor Information Santosh Kumar More articles by this author Muninder Singh Randhawa More articles by this author Raguram Ganesamoni More articles by this author Shrawan K. Singh More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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• W1983728631 title "Tranexamic Acid Reduces Blood Loss During Percutaneous Nephrolithotomy: A Prospective Randomized Controlled Study" @default.
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