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<p>Intravenous tranexamic acid (TXA) is increasingly used to reduce perioperative bleeding. Its safety in bariatric surgery, a population with chronic inflammation and hypercoagulability, remains unclear. Following PRISMA guidelines, 11 comparative studies (five RCTs, four retrospective cohorts, two prospective cohorts; <i>n</i> = 1,959) were analyzed. TXA significantly reduced transfusion risk (RR 0.29, 95%CI 0.11–0.80), bleeding events (RR 0.46, 95%CI 0.32–0.67), postoperative hemoglobin reduction (MD 0.24&#xa0;g/dL, 95%CI 0.04–0.44), length of stay, and operative time. Intraoperative blood loss was unchanged. RCT-only analyses showed consistent reductions in bleeding and hemoglobin drop. No deep venous thromboembolism events were reported. Overall, TXA may reduce bleeding-related outcomes in bariatric surgery without an observed thromboembolic signal, though low event rates limit certainty, and further randomized trials are needed. Word count: 120/125.</p>

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Efficacy and Safety of Tranexamic Acid Use in Bariatric Surgery: An Updated Systematic Review and Meta-Analysis

  • 期刊论文

  • 发表日期：

    2026年4月8日

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  • Lily J Park,
  • Hannah Polley,
  • Meredith Poole,
  • Karanbir Brar,
  • Tyler McKechnie,
  • Rahima Nenshi,
  • Flavia K Borges,
  • Sandra Ofori,
  • Maura Marcucci,
  • David Conen,
  • Yung Lee,
  • Mehran Anvari,
  • Cagla Eskicioglu,
  • Dennis Hong,
  • PJ Devereaux

摘要

Intravenous tranexamic acid (TXA) is increasingly used to reduce perioperative bleeding. Its safety in bariatric surgery, a population with chronic inflammation and hypercoagulability, remains unclear. Following PRISMA guidelines, 11 comparative studies (five RCTs, four retrospective cohorts, two prospective cohorts; n = 1,959) were analyzed. TXA significantly reduced transfusion risk (RR 0.29, 95%CI 0.11–0.80), bleeding events (RR 0.46, 95%CI 0.32–0.67), postoperative hemoglobin reduction (MD 0.24 g/dL, 95%CI 0.04–0.44), length of stay, and operative time. Intraoperative blood loss was unchanged. RCT-only analyses showed consistent reductions in bleeding and hemoglobin drop. No deep venous thromboembolism events were reported. Overall, TXA may reduce bleeding-related outcomes in bariatric surgery without an observed thromboembolic signal, though low event rates limit certainty, and further randomized trials are needed. Word count: 120/125.