Purpose: To evaluate the efficacy and safety of Tranexamic acid in reducing
blood loss during PCNL. Materials and Methods: A total of 50 patients who
underwent unilateral Percutaneous Nephrolithotomy from March 2017 to
November 2017 were randomized into 2 equal groups; group (A) who received
1 gm (10 cc) of tranexamic acid ampule on call to surgery and group
(B) who received (10 cc) normal saline. The Patients clinical data were collected
and recorded in Microsoft Excel 2016 and analyzed using Statistical
Package for the Social Science (SPSS) version 20 software program. Results:
Fifty patients were included in the study: (33 males and 17 female). The mean
age in group A patients was (48.12 ± 13.58) years, and in group B was
(48.88 ± 16.17) with P value = 0.858. In group A the number of males was 16
(64%), and female was 9 (36%), and in group B male was 17 (68%) and female
was 8 (34%). Mean body mass index (BMI) in group A was (28.58 ± 4.51) and
in group B was (26.72 ± 3.71), with P value = 0.119 which is statistically not
significant. The mean total blood loss in milliliters in group A was (73.80 ±
60.1), while in group B it was (117.24 ± 87.9) which is statistically significant
with P-Value = 0.047. The mean hemoglobin drop in group A was (0.45 ±
0.35 g/dl) while in group B was (1.00 ± 0.46 g/dl), which is statistically significant
with P value = 0.0001. The mean operative time was (48.4 ± 17) minute
in group A, while it was (62.4 ± 15) in group B, with P-Value = 0.005, which
is statistically was significant. Post-operative hematuria in group A; 20 (80%)
patients had mild hematuria, 3 (12%) patients had moderate hematuria and 2
patients (8%) had no hematuria. In group B; 18 (72%) patients had mild hematuria,
6 (24%) patients had moderate hematuria and one patient (4%) had
no hematuria, which is statistically not significant with P-Value = 0.487 (Table
2). One patient (4%) had intra operative bleeding in group A, in group B
two patients (8%) had bleeding with P value of 0.79 which statistically not significant. Conclusion: Tranexamic acid is safe and effective drug in reducing
blood loss and the rate of blood transfusion in percutaneous nephrolithotomy.
It is associated with fewer intraoperative, postoperative complications
and shorter operative time.
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