Effect of Tranexamic Acid on Blood Loss in Percutaneous Nephrolithotomy

Introduction Percutaneous nephrolithotomy (PCNL) is a minimally invasive method of treatment for large kidney stones. Bleeding is one of the serious complications associated with this type of surgical intervention. Objectives of the study To evaluate the efficiency and safety of tranexamic acid in reducing blood loss and transfusion requirements in patients with kidney stones treated by percutaneous nephrolithotomy. Materials& methodsA total of 141 patients diagnosed with renal calculus who underwent percutaneous nephrolithotomy from August 2013 July 2016 were included. The staghorn to non-staghorn calculi ratio was 12. Most procedures were completed through a single percutaneous tract. The patients were divided in two groups 69 (group 1) received one hour prior to surgery 1 g Exacyl (tranexamic acid) in 250 ml saline solution 0.9 % with slow infusion (1 hour), infusion with the same dose was repeated 12 hours postsurgery, while 72 patients (group 2) did not receive tranexamic acid. The clinical data were compared. Results The mean hemoglobin drop in the tranexamic acid group was significantly lower than that of the control group (1.1 g vs 2.4 g). The transfusion rate was also higher in the control group (6 patients vs.1 patient). The postoperative complications were represented by postoperative pain (25.5 %), fever (12.7) %, hematuria (19.1 %), urinary sepsis (only one case 2.1 %). Conclusions Tranexamic acid in percutaneous nephrolithotomy is safe, affordable and is associated with lesser blood loss and a lower transfusion rate