Single Dose of Intravenous Tranexamic Acid for Reduce Blood Loss from Surgical Staging in Endometrial Cancer: A randomized controlled trial

Abstract

Objectives: To study the efficacy of single dose of intravenous tranexamic acid administration in reducing of intraoperative blood loss during surgical staging in endometrial cancer.
Materials and Methods: A randomized double-blinded, placebo-controlled trial was conducted. Thirty-four women who were diagnosed of endometrial cancer by tissue pathology and scheduled for surgical staging by gynecologic oncologists at Khon Kaen Hospital from November 2018 to May 2019 were randomized into two groups; 17 were allocated to receive intravenous tranexamic acid and 17 received placebo. Intraoperative measurement blood loss was recorded and analyzed.
Results: Both groups had similar baseline characteristics. The result of study presented that the measurement intraoperative blood loss in intravenous tranexamic acid group was significantly lower than control group (295.88 (256.01-335.87) vs. 613.94 (535.9-691.98) ml, p < 0.001) with mean difference was 318.05 ± 87.63 ml (95% confidence interval (CI) 139.54-496.56). There had 2 and 10 cases of intraoperative blood loss ≥ 500 ml in intravenous tranexamic acid and control group, respectively (number need to treat = 12.5 and relative risk 0.24; 95%CI 0.06-0.89, p = 0.004).
Conclusion: Single dose of intravenous tranexamic acid given 15 minutes before surgery could significantly reduce measurement blood loss in surgical staging for endometrial cancer without serious adverse side effect.