TRANEXAMIC ACID IN ELECTIVE ABDOMINAL SURGERY: A SYSTEMATIC REVIEW AND META-ANALYSIS leonardoglz.bs@gmail.com

PW07-11

TRANEXAMIC ACID IN ELECTIVE ABDOMINAL SURGERY: A SYSTEMATIC REVIEW AND META-ANALYSIS

4

Mexico

Poster with Discussion

Tranexamic acid (TXA) is widely used to reduce bleeding in trauma and orthopedic surgery, but its role in elective abdominal procedures remains less defined. This study evaluated the efficacy and safety of perioperative TXA in elective abdominal operations.

A systematic review was conducted through July 2025 in PubMed, Embase, and Google Scholar. We included randomized controlled trials (RCTs) and prospective cohort studies comparing intravenous TXA to placebo or no treatment in adult patients undergoing elective abdominal surgery. Outcomes included blood loss, RBC transfusion requirements, thrombotic events, and mortality. Risk of bias was assessed using RoB-2 and ROBINS-I, and meta-analysis was performed using random-effects models in RevMan 5.4.

Eleven studies were included (9 RCTs, 2 cohort studies), totaling over 12,350 patients. TXA significantly reduced intraoperative blood loss (Std. Mean Difference, 95% CI:-0.42 [-0.73, -0.12]; p = 0.006; I² = 77%) and the proportion of patients requiring red blood cell transfusion (Risk Ratio [RR]: 0.70; 95% CI: 0.49–1.00; p = 0.05; I² = 49%). No statistically significant difference was observed in thrombotic events (RR: 0.85; 95% CI: 0.30–1.14; p = 0.11) or mortality (RR: 1.09; 95% CI: 0.78–1.54; p = 0.60). Subgroup analyses suggested greater efficacy in hepatic surgeries and when lower TXA doses were used (≤1 g Bolus or ≤15 mg/Kg).

TXA reduces blood loss and transfusion needs in elective abdominal surgery without increasing thrombotic or mortality risk. Its selective use, especially in hepatic surgery cases, is supported by current evidence.