Evidence map›Paper›PMID 38168716›Full record

ArticleObesity surgery2024

Intra-operative Tranexamic Acid Administration Significantly Decreases Incidence of Postoperative Bleeding Without Increasing Venous Thromboembolism Risk After Laparoscopic Sleeve Gastrectomy: a Retrospective Cohort Study of Over 400 Patients.

Naveed Hossain, Vasha Kaur, Mostafa Mahran, Abdul Quddus, Santanu Mukhopadhyay, Akshat Shah, Sanjay Agrawal

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In one paragraph

Article in Obesity surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 5 pooled it
5.7field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 5 syntheses or guidelines pooled it, 10 citations in OpenAlex.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Naveed HossainDepartment of Bariatric Surgery, Homerton University Hospital, Homerton Row, London, E9 6SR, UK.ORCID 0000-0003-4659-541X
Vasha KaurDepartment of Bariatric Surgery, Homerton University Hospital, Homerton Row, London, E9 6SR, UK.
Mostafa MahranDepartment of Bariatric Surgery, Homerton University Hospital, Homerton Row, London, E9 6SR, UK.
Abdul QuddusDepartment of Bariatric Surgery, Homerton University Hospital, Homerton Row, London, E9 6SR, UK.
Santanu MukhopadhyayDepartment of Anaesthesia, Homerton University Hospital, Homerton Row, London, E9 6SR, UK.
Akshat ShahDepartment of Anaesthesia, Homerton University Hospital, Homerton Row, London, E9 6SR, UK.
Sanjay AgrawalDepartment of Bariatric Surgery, Homerton University Hospital, Homerton Row, London, E9 6SR, UK. sanju_agrawal@hotmail.com.
Homerton University Hospital · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere is evidence that tranexamic acid (TXA) reduces surgical bleeding and is widely used in trauma, obstetrics and other specialties. This practice is less well-established in laparoscopic sleeve gastrectomy (LSG) due to concerns surrounding venous thromboembolism (VTE); equally postoperative bleeding is a serious complication often requiring re-operation.

methodsThis retrospective cohort study compared 30-day outcomes following primary LSG in patients receiving intra-operative TXA (March 2020-July 2022) to those who did not (March 2011-March 2020). The primary outcome was postoperative bleeding (Hb < 9 g/dL) requiring transfusion or re-operation. Secondary outcomes were incidence of VTE, serious postoperative complications (Clavien-Dindo > grade 3) and death. Patients underwent standardised-protocol LSG without staple line re-enforcement under a single surgeon within the independent sector (private practice). TXA 1 g intravenous was administered immediately after a methylene blue leak test, prior to extubation.

resultsTXA group had 226 patients and non-TXA group had 192 patients. Mean age was 40.5 ± 10.3 and 39.1 ± 9.8 years, respectively. In the TXA group, no postoperative bleeds [versus 3 (1.6%) in non-TXA group, p = 0.0279] occurred. One staple line leak (0.4%) occurred in the TXA group compared to zero in the non-TXA group (p = ns). There was no VTE or death.

conclusionsThis is the largest cohort study of intra-operative TXA in primary LSG to date, which demonstrates significant decrease in postoperative bleeding without increasing VTE risk. The authors recommend administration of TXA immediately following leak test, or removal of bougie to maximise efficacy. Data of TXA in LSG is awaited from the randomised controlled PATAS trial.

Indexed as

LaparoscopyObesity, MorbidTranexamic AcidVenous ThromboembolismAdultCohort StudiesGastrectomyHumansIncidenceMiddle AgedPostoperative HemorrhageRetrospective StudiesTreatment OutcomeTranexamic AcidBariatric surgeryLaparoscopic sleeve gastrectomyLSGPostoperative bleedingSleeve gastrectomyTranexamic acidTXA

Identifiers

PMID38168716
OpenAlexW4390521872

What OpenQuestion holds

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Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.