Analysis of the effectiveness and safety of tranexamic acid in the prevention of bleeding after bariatric surgeries: A retrospective study

Introduction. Bariatric surgery is a safe method of weight loss when performed in certified centers by surgeons who have completed the learning curve. However, there is still a risk of serious complications of bariatric operations. According to most studies, major bleeding is the main cause of increased postoperative morbidity and prolonged hospital stay.

Aim. To evaluate the effectiveness and safety profile of tranexamic acid (TXA) in the prevention of bleeding after bariatric surgeries.

Materials and methods. We analyzed medical records of all patients who underwent primary bariatric surgeries according to standard protocols. A total of 2,524 bariatric interventions were performed from 2016 to 2024. From 2016 to 2023, 1,983 operations were performed – a group of patients who did not routinely receive TXA intraoperatively. From January to December 2024, 541 surgical interventions were performed – a group of patients whose surgery ended with intravenous administration of 1,000 mg of TXA.

Results. In the postoperative period, 32 cases of bleeding (1.6%) were registered in the group of patients where TXA was not used intraoperatively, whereas no no cases (0%) of major bleeding were observed in the group where TXA was used (0%; p = 0.0279). Intraluminal bleeding was recorded in 3 cases, all 3 cases were identified during Roux-en-Y gastric bypass.

Conclusions. TXA is an effective complement to careful surgical technique for bariatric operations to reduce the risk of bleeding and improve outcomes due to its availability, cost-effectiveness, rapid onset of action, and systemic effect.

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