Intravenous Tranexamic Acid Improves the Intraoperative Visualization of Endoscopic Sinus Surgery for High-Grade Chronic Rhinosinusitis: A Randomized, Controlled, Double-Blinded Prospective Trial

Objective: Intraoperative bleeding during endoscopic sinus surgery (ESS) for high-grade rhinosinusitis can be serious and can further obscure the surgical field. This study was designed to evaluate the effect of tranexamic acid (TXA) on the surgical visualization of ESS for high-grade rhinosinusitis...

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Autores principales:	Wenjing Yang, Haoling Gou, He Li, Ying Liu, Ying Wan, Chengshuo Wang, Guyan Wang, Luo Zhang
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	tranexamic acid hemostasis chronic rhinosinusitis endoscopic sinus surgery Sonoclot analysis Surgery RD1-811
Acceso en línea:	https://doaj.org/article/d6f5068be03c4656ac37f8a8362e34d1
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spelling	oai:doaj.org-article:d6f5068be03c4656ac37f8a8362e34d12021-11-16T05:04:35ZIntravenous Tranexamic Acid Improves the Intraoperative Visualization of Endoscopic Sinus Surgery for High-Grade Chronic Rhinosinusitis: A Randomized, Controlled, Double-Blinded Prospective Trial2296-875X10.3389/fsurg.2021.771159https://doaj.org/article/d6f5068be03c4656ac37f8a8362e34d12021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fsurg.2021.771159/fullhttps://doaj.org/toc/2296-875XObjective: Intraoperative bleeding during endoscopic sinus surgery (ESS) for high-grade rhinosinusitis can be serious and can further obscure the surgical field. This study was designed to evaluate the effect of tranexamic acid (TXA) on the surgical visualization of ESS for high-grade rhinosinusitis.Methods: In total, 60 patients with high-grade chronic rhinosinusitis (Lund-Mackay score 12 or greater) treated by ESS were randomized into two groups: the control group (Group C) or the TXA group (Group T). Each group included 30 patients. Patients in Group T received intravenous TXA, and those in Group C received normal saline. The Boezaart grading scale (BS) score was assessed as the primary outcome. Total blood loss (TBL), whole blood coagulation, and fibrinolysis were assessed by Sonoclot analysis, and complications were recorded and compared between the groups.Result: A significant difference was found in the BS score between Group T and Group C [2.02 (1.88–2.05) vs. 2.27 (2.13–2.41), P = 0.011]. Increases in platelet function (PF) and fibrin degradation time (FDT) were assessed during the operation and showed significant differences between Group T and Group C (P = 0.040 for PF; P = 0.010 for FDT). No difference in complications was found between the two groups.Conclusion: A 15 mg/kg bolus of intravenous TXA before surgery can improve the surgical visualization of ESS for high-grade chronic rhinosinusitis without causing significant adverse effects. Intravenous TXA may be beneficial in ESS for high-grade chronic rhinosinusitis.Clinical Trial Registration:https://www.chictr.org.cn/edit.aspx?pid=121653&htm=4.Wenjing YangHaoling GouHaoling GouHe LiYing LiuYing WanChengshuo WangGuyan WangLuo ZhangFrontiers Media S.A.articletranexamic acidhemostasischronic rhinosinusitisendoscopic sinus surgerySonoclot analysisSurgeryRD1-811ENFrontiers in Surgery, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	tranexamic acid hemostasis chronic rhinosinusitis endoscopic sinus surgery Sonoclot analysis Surgery RD1-811
spellingShingle	tranexamic acid hemostasis chronic rhinosinusitis endoscopic sinus surgery Sonoclot analysis Surgery RD1-811 Wenjing Yang Haoling Gou Haoling Gou He Li Ying Liu Ying Wan Chengshuo Wang Guyan Wang Luo Zhang Intravenous Tranexamic Acid Improves the Intraoperative Visualization of Endoscopic Sinus Surgery for High-Grade Chronic Rhinosinusitis: A Randomized, Controlled, Double-Blinded Prospective Trial
description	Objective: Intraoperative bleeding during endoscopic sinus surgery (ESS) for high-grade rhinosinusitis can be serious and can further obscure the surgical field. This study was designed to evaluate the effect of tranexamic acid (TXA) on the surgical visualization of ESS for high-grade rhinosinusitis.Methods: In total, 60 patients with high-grade chronic rhinosinusitis (Lund-Mackay score 12 or greater) treated by ESS were randomized into two groups: the control group (Group C) or the TXA group (Group T). Each group included 30 patients. Patients in Group T received intravenous TXA, and those in Group C received normal saline. The Boezaart grading scale (BS) score was assessed as the primary outcome. Total blood loss (TBL), whole blood coagulation, and fibrinolysis were assessed by Sonoclot analysis, and complications were recorded and compared between the groups.Result: A significant difference was found in the BS score between Group T and Group C [2.02 (1.88–2.05) vs. 2.27 (2.13–2.41), P = 0.011]. Increases in platelet function (PF) and fibrin degradation time (FDT) were assessed during the operation and showed significant differences between Group T and Group C (P = 0.040 for PF; P = 0.010 for FDT). No difference in complications was found between the two groups.Conclusion: A 15 mg/kg bolus of intravenous TXA before surgery can improve the surgical visualization of ESS for high-grade chronic rhinosinusitis without causing significant adverse effects. Intravenous TXA may be beneficial in ESS for high-grade chronic rhinosinusitis.Clinical Trial Registration:https://www.chictr.org.cn/edit.aspx?pid=121653&htm=4.
format	article
author	Wenjing Yang Haoling Gou Haoling Gou He Li Ying Liu Ying Wan Chengshuo Wang Guyan Wang Luo Zhang
author_facet	Wenjing Yang Haoling Gou Haoling Gou He Li Ying Liu Ying Wan Chengshuo Wang Guyan Wang Luo Zhang
author_sort	Wenjing Yang
title	Intravenous Tranexamic Acid Improves the Intraoperative Visualization of Endoscopic Sinus Surgery for High-Grade Chronic Rhinosinusitis: A Randomized, Controlled, Double-Blinded Prospective Trial
title_short	Intravenous Tranexamic Acid Improves the Intraoperative Visualization of Endoscopic Sinus Surgery for High-Grade Chronic Rhinosinusitis: A Randomized, Controlled, Double-Blinded Prospective Trial
title_full	Intravenous Tranexamic Acid Improves the Intraoperative Visualization of Endoscopic Sinus Surgery for High-Grade Chronic Rhinosinusitis: A Randomized, Controlled, Double-Blinded Prospective Trial
title_fullStr	Intravenous Tranexamic Acid Improves the Intraoperative Visualization of Endoscopic Sinus Surgery for High-Grade Chronic Rhinosinusitis: A Randomized, Controlled, Double-Blinded Prospective Trial
title_full_unstemmed	Intravenous Tranexamic Acid Improves the Intraoperative Visualization of Endoscopic Sinus Surgery for High-Grade Chronic Rhinosinusitis: A Randomized, Controlled, Double-Blinded Prospective Trial
title_sort	intravenous tranexamic acid improves the intraoperative visualization of endoscopic sinus surgery for high-grade chronic rhinosinusitis: a randomized, controlled, double-blinded prospective trial
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/d6f5068be03c4656ac37f8a8362e34d1
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Intravenous Tranexamic Acid Improves the Intraoperative Visualization of Endoscopic Sinus Surgery for High-Grade Chronic Rhinosinusitis: A Randomized, Controlled, Double-Blinded Prospective Trial

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