The role of intraoperative tranexamic acid in transurethral resection of the prostate: a systematic review and meta-analysis of randomised-controlled trials.

IF 1.9 4区医学 Q3 UROLOGY & NEPHROLOGY

International Urology and Nephrology Pub Date : 2026-05-07 DOI:10.1007/s11255-026-05180-7

Cian M Hehir, Gavin G Calpin, Gavin P Dowling, Gordon R Daly, Barry B McGuire

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引用次数: 0

Abstract

Purpose: To critically appraise and evaluate the safety and efficacy of intraoperative tranexamic acid (TXA) administration during transurethral resection of the prostate (TURP).

Methods: A systematic search of online databases was conducted to identify randomised-controlled trials (RCTs) which compared surgical outcomes and complication rates in patients undergoing TURP for benign prostatic hyperplasia (BPH) who were treated with TXA (intervention) as compared to placebo/none (control). The efficacy of intraoperative TXA was evaluated through outcomes related to blood loss, rate of blood transfusion and operative time. The safety of TXA was evaluated through pooled analysis of both deep venous thrombosis and pulmonary emboli.

Results: Nine RCTs met the inclusion criteria for this meta-analysis in which a total of 661 patients underwent TURP for BPH (331 TXA: 330 Control). There was significantly less intraoperative bleeding in the TXA group (MD -40.23 mL [95%CI -66.76 to -13.71], p = 0.003), which was reflected in a significantly lesser haemoglobin drop on the first postoperative day (MD -0.55 g/dL [95%CI -0.71 to -0.39], p < 0.00001). TXA was associated with a significantly shorter operative time (MD -9.77 min [95%CI -16.97 to -2.58], p = 0.008), with patients who received TXA exposed to a significantly reduced risk of blood transfusion (0.99% TXA vs. 7.69% Control, OR 0.16 [95%CI 0.03-0.93], p = 0.04). There was no statistically significant increase in risk of DVT in the TXA group, p = 0.46.

Conclusion: Intraoperative administration of TXA is safe and effective in reducing intraoperative blood loss, operative time and postoperative haemoglobin (Hb) drop with resultant decrease in blood transfusion requirements. This meta-analysis did not detect any significant increase in venous thrombosis or risk of pulmonary embolism incurred by TXA administration.

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术中氨甲环酸在经尿道前列腺切除术中的作用：随机对照试验的系统回顾和荟萃分析。

目的：对经尿道前列腺切除术（TURP）术中给药氨甲环酸（TXA）的安全性和有效性进行批判性评价。方法：对在线数据库进行系统检索，以确定随机对照试验（rct），这些试验比较了接受TURP治疗的良性前列腺增生（BPH）患者接受TXA治疗（干预）与安慰剂/无TXA治疗（对照组）的手术结果和并发症发生率。通过出血量、输血率、手术时间等指标评价术中TXA的疗效。通过深静脉血栓形成和肺栓塞的合并分析来评估TXA的安全性。结果：9项随机对照试验符合本荟萃分析的纳入标准，其中共有661例患者接受了前列腺增生手术（331例TXA: 330例对照）。TXA组术中出血明显减少（MD -40.23 mL [95%CI -66.76 ~ -13.71], p = 0.003），这反映在术后第一天血红蛋白下降明显减少(MD -0.55 g/dL [95%CI -0.71 ~ -0.39]， p结论：术中给予TXA安全有效地减少术中出血量、手术时间和术后血红蛋白（Hb）下降，从而减少输血需求。这项荟萃分析没有发现任何显著增加静脉血栓形成或肺栓塞的风险由TXA引起。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Urology and Nephrology 医学-泌尿学与肾脏学

CiteScore

3.40

自引率

5.00%

发文量

329

审稿时长

1.7 months

期刊介绍： International Urology and Nephrology publishes original papers on a broad range of topics in urology, nephrology and andrology. The journal integrates papers originating from clinical practice.