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Single-dose tranexamic acid in advanced ovarian cancer surgery reduces blood loss and transfusions: double-blind placebo-controlled randomized multicenter study
Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
Linköping University, Department of Clinical and Experimental Medicine, Division of Inflammation Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Orthopaedics in Linköping.
Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Clinical Physiology in Linköping.
Kalmar County Hospital, Sweden .
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2014 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 93, no 4, 335-344 p.Article in journal (Refereed) Published
Abstract [en]

ObjectiveTo determine whether single-dose tranexamic acid given intravenously immediately before surgery for presumed advanced ovarian cancer reduces perioperative blood loss and blood transfusions. DesignA randomized double-blind, placebo-controlled multicenter study. SettingTwo university hospitals and two central hospitals in the southeast health region of Sweden. PopulationOne hundred women with presumed advanced ovarian cancer scheduled for radical debulking surgery between March 2008 and May 2012 who complied with inclusion/exclusion criteria were randomized; 50 were allocated to receive tranexamic acid and 50 to receive placebo. Analysis was performed according to intention-to-treat principles. MethodsThe volume of tranexamic acid (15mg/kg body weight, 100mg/mL tranexamic acid) or the same volume of placebo (0.9% NaCl) was added to a 100-mL saline solution plastic bag. The study medication was given immediately before the start of surgery. Data were analyzed by means of non-parametric statistics and multivariate models adjusted for confounding factors. Main outcome measuresBlood loss and red blood cell transfusions. ResultsThe total blood loss volume and transfusion rate were significantly lower in the tranexamic acid group compared with the placebo group. Median total blood loss was 520 and 730mL, respectively (p=0.03). Fifteen (30%) and 22 (44%), respectively received transfusions (odds ratio 0.44; upper 95% CI 0.97; p=0.02). ConclusionA single dose of tranexamic acid given immediately before surgery reduces blood loss and transfusion rates significantly in advanced ovarian cancer surgery. Tranexamic acid may be recommended as standard prophylactic treatment in advanced ovarian cancer surgery.

Place, publisher, year, edition, pages
Informa Healthcare / Wiley , 2014. Vol. 93, no 4, 335-344 p.
Keyword [en]
Blood loss; ovarian cancer; randomized trial; surgery; tranexamic acid; transfusion
National Category
Clinical Medicine
Identifiers
URN: urn:nbn:se:liu:diva-106118DOI: 10.1111/aogs.12333ISI: 000333150700003OAI: oai:DiVA.org:liu-106118DiVA: diva2:714048
Available from: 2014-04-25 Created: 2014-04-24 Last updated: 2017-12-05

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Johansson, TorstenZachrisson, HeleneKjölhede, Preben

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Johansson, TorstenZachrisson, HeleneKjölhede, Preben
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Division of Clinical SciencesFaculty of Health SciencesDepartment of Gynaecology and Obstetrics in LinköpingDivision of Inflammation MedicineDepartment of Orthopaedics in LinköpingDivision of Cardiovascular MedicineDepartment of Clinical Physiology in Linköping
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Acta Obstetricia et Gynecologica Scandinavica
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