Ali YAVUZCAN, Yusuf ÜSTÜN, Serdar DİLBAZ, Mete ÇAĞLAR, Selahattin KUMRU, Atilla ÖZKARA

Laparaskopik Histerektomi'deTraneksamik Asit Kullanımı

Amaç: Bu çalışmanın amacı preoperatif dönemde traneksamik asit (TA) uygulanmasının laparaskopik histerektomide (LH) operasyon süresi, preoperatif-postoperatif dönem arasındaki hemoglobin (Hb) değişimi (delta Hb) ve hospitalizasyon süresi üzerine etkisini değerlendirmektir. Materyal-Metod: Adneksektomi dâhilya da hariç olmak üzere LH ile birlikte tanısal sistoskopi (CYS) işlemi yapılan hastalar çalışmaya dahil edilmiştir. Operasyonların hepsi aynı cerrah tarafından gerçekleştirilmiştir. Bulgular: TA kullanılan hastalar ile kullanılmayan hastalar arasında hasta yaşı ve uterin ağırlık açısından istatistiksel olarak anlamlı farklılık saptanmamıştır (p=0,714 ve p=0,955 sırasıyla). Ancak ortalama parite sayısı TA uygulanan grupta istatistiksel olarak anlamlı olacak şekilde düşük tespit edilmiştir (p=0,006). Operasyonda TA uygulanan hastalar ile uygulanmayan hastalar arasında operasyon süresi (p=0,962), delta Hb (p=0,870) ve hospitalizasyon süresi (p=0,759) açısından istatistiksel olarak anlamlı farklılık saptanmamıştır. Sonuç: Çalışmamızda TA uygulanmasının LHde operasyon sonuçları üzerine olumlu etkisi gösterilememiştir. Konvansiyonel olarak yapılan açık cerrahi işlemlerde kan kaybını azalttığı ispatlanmış olan TAnın minimal invaziv yöntemlerle yapılan operasyonlardaki etkinliğinin net olarak ortaya konabilmesi için geniş kapsamlı yeni araştırmalara gerek duyulmaktadır.

Tranexamic Acid Use in Laparascopic Hysterectomy

Objective:The aim of this study was to evaluate the effect of using systemic tranexamic acid (TA) preoperatively on operation time, difference in hemoglobin (Hb) levels measured before and after surgery (delta Hb) and duration of hospitalization in laparoscopic hysterectomy (LH). Materials and Methods:The patients undergone LH with cystoscopy (CYS) with or without adnexectomy were included in this study. All the operations were carried out by the same surgeon. Results: The patients receiving TA and patients not receiving TA were compared in terms of age and uterine weight There was no statistically significant difference between two groups in terms of age and uterine weight (p = 0.714 and p = 0.955, respectively). However, the average number of parity was to be significantly lower in the patients receiving TA (p = 0.006). There was not any statistically significant difference between the patients who received TA and who did not recieve in terms operative time (p =0.962), delta Hb (p = 0.870) and duration of hospitalization (p = 0.759). Conclusion: Our study did not demonstrate a positive effect of tranexamic acid after systemic administration on peri operative outcomes of LH. The effectiveness of TA in convention al open surgical procedures to reduce blood loss has been proven but further investigations to clarify the effectivity of TA on minimally invasive surgical approaches are needed.

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