The effects of tranexamic acid on blood loss and transfusion rate in colorectal surgery

Background: The present study aimed to evaluate safety of tranexamic acid (TA) administration and to assess bleeding risk in colorectal surgery (CRS). Methods: Retrospective cohort study including consecutive patients undergoing elective CRS by a single surgeon between August 2014 and May 2015. All patients received 1 g of TA intravenously at induction and at closure. Demographics, operative and postoperative details were prospectively assessed and compared to a historical control cohort. Results: 213 patients were evaluated. TA did not increase complications, readmissions, or reoperation rates. Significant postoperative hemoglobin (Hgb) drop (≥3 g/dL) (TA: n = 6, 7.4%, Control: n = 22, 16.6%; p = 0.193) and transfusion rates (intraoperative: TA: n = 2, 2.5%, Control: n = 2, 1.5%; p = 0.586, postoperative: TA: n = 1, 1.2%, Control: 9, 6.8%; p = 0.065) were not statistically different. Conclusions: Postoperative hemoglobin drop and transfusion rates were not decreased statistically. Further study is warranted given the large clinical differences in favor of TA.