• Nolan J Brown, Bayard Wilson, Vera Ong, Julian L Gendreau, Chen Yi Yang, Alexander S Himstead, Shane Shahrestani, Nathan A Shlobin, Taylor Reardon, Elliot H Choi, Jack Birkenbeuel, Sebastian J Cohn, Ronald Sahyouni, and Isaac Yang.
• Department of Neurological Surgery, University of California Irvine, Irvine, California, USA.
• World Neurosurg. 2022 Apr 1; 160: e209-e219.

BackgroundAs an established antifibrinolytic agent, tranexamic acid (TXA) has garnered widespread use during surgery to limit intraoperative blood loss. In the field of neurosurgery, TXA is often introduced in cases of traumatic brain injury or elective spine surgeries; however, its role during elective cranial surgeries is not well established. We report a systematic review of the use of TXA in elective surgical resection of intracranial neoplasms.MethodsWe performed this systematic review following PRISMA guidelines to identify studies investigating the use of TXA in elective neurosurgical resection of intracranial neoplasms. Variables extracted included patient demographics, surgical indications, type of surgery performed, TXA dose and route of administration, operative duration, blood loss, transfusion rate, postoperative hemoglobin level, and complications.ResultsAfter careful screening, 4 articles (consisting of 682 patients) met our inclusion/exclusion criteria. The studies included 2 prospective cohort studies, 1 retrospective cohort study, and 1 case series. A χ2 test of pooled data demonstrated that patients administered TXA had a significantly decreased need for blood transfusions during surgery (odds ratio, 0.6273; 95% confidence interval, 0.4254-0.9251; P = 0.018). Mean total blood loss was 821.9 mL in the TXA group and 1099.0 mL in the control group across the studies. There was no significant difference in postoperative hemoglobin levels, with a mean of 11.4 g/dL in both the TXA and control groups.ConclusionsThese results support the use of intraoperative TXA in tumor resection. However, its role in tumor resection has been less well investigated compared with its use in other areas of neurosurgery.Copyright © 2022 Elsevier Inc. All rights reserved.

15 keywords...

hide…