Supervisors info:
Δημήτριος Θεοδώρου, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Γεώργιος Ζωγράφος, Ομότιμος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Κωνσταντίνος Τούτουζας, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Summary:
Introduction: Hemorrhage after bariatric surgery is a well-recognized intraoperative and immediate postoperative complication estimated up to 4% in the existing literature. The morbidity and mortality that emerge, underline the importance of formulating recommendations for its treatment. Among other strategies, the use of tranexamic acid (TXA) has been proposed for the prevention and conservative treatment of this particular complication.
The purpose of this study is to systematically review the current literature regarding the administration of tranexamic acid as a treatment against bleeding, in patients undergoing bariatric surgery, both preventively and therapeutically, including its most frequent side effects. The general section refers to the definition of obesity, the epidemiology, complications and treatment of the disease, but also includes a detailed description of the pharmaceutical characteristics of tranexamic acid. The special section consists of:
Methods: The Pubmed database and the ScienceDirect database were searched for all possible combinations of the phrase tranexamic acid and bariatric surgery with the words management, bleeding, surgery, bleeding control, side effects.
Results: The search yielded 64 published studies. After removing the duplicate publications, 62 articles were assessed and 42 were excluded based on title and abstract. Of the remaining 20 articles, 11 articles were also removed due to irrelevant content. 9 articles were evaluated, regarding the use of tranexamic acid in patients undergoing bariatric metabolic surgery, both as a preventive measure and as a therapeutic treatment, in relation to its most frequent possible side effects.
Discussion: TXA appears, in the present literature, to be an effective and safe option in reducing bleeding complications in metabolic surgery, mainly after SG. However, there is an urgent need for a larger number of studies, with higher numbers of patients, in order to strongly document the drug's indications in the surgeon's quiver, in bariatric procedures.
Keywords:
Bariatric metabolic surgery, Bleeding, Tranexamic acid, Complications, Venous thromboembolic disease
