The role of tranexamic acid in reducing post-operative bleeding and seroma formation in breast surgery: A meta-analysis.
Surgeon
; 21(4): e183-e194, 2023 Aug.
Article
en En
| MEDLINE
| ID: mdl-36572609
ABSTRACT
INTRODUCTION:
Tranexamic acid (TXA) reduces blood loss and blood transfusion requirements in surgery. Seroma and haematoma formation occur as complications of breast surgery. We aimed to perform a meta-analysis evaluating TXA in reducing post-operative haematoma and seroma formation for breast surgery.METHODS:
A systematic review was performed in accordance with PRISMA guidelines. Results were expressed as dichotomous variables pooled as odds ratios (OR) with corresponding 95% confidence intervals (CIs) using the Mantel-Haenszel method.RESULTS:
Seven studies including 1446 patients were included. There were 1830 breast surgery procedures performed with TXA administered in 797 cases (43.6%). There was a significant reduction in haematoma rates in the TXA group (TXA 3.184% (22/691) vs Control 6.787% (64/943), OR 0.41, 95% CI 0.20-0.86, P = 0.020). Based on surgical procedure, haematoma rates were similar for TXA and control groups in cancer surgery (P = 0.230). Haematoma rates reduced following TXA use in cosmetic procedures (TXA 3.807% (15/394) vs. Control 9.091% (34/374), OR 0.41, 95% CI 0.22-0.75, P = 0.004). Haematoma rates were also reduced in procedures where axillary lymph node dissection (ALND) was not performed; in the TXA group, 3.379% (22/651) developed a haematoma versus 6.623% (60/906) in the control group (OR 0.45, 95% CI 0.27-0.77, P = 0.003). TXA administration did not impact seroma formation or infection rates.CONCLUSION:
Perioperative administration of TXA may impact the incidence of haematoma in breast surgery, particularly in cosmetic procedures and procedures without ALND. Well-designed randomised studies are required to determine its true efficacy. TXA has no effect on seroma formation or infection in breast surgery.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Ácido Tranexámico
/
Neoplasias de la Mama
/
Antifibrinolíticos
Tipo de estudio:
Clinical_trials
/
Systematic_reviews
Límite:
Female
/
Humans
Idioma:
En
Revista:
Surgeon
Año:
2023
Tipo del documento:
Article