{"id":26637,"date":"2024-10-17T04:10:00","date_gmt":"2024-10-16T20:10:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=26637"},"modified":"2024-10-17T05:37:32","modified_gmt":"2024-10-16T21:37:32","slug":"jama-netw-open%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e8%82%9d%e8%84%8f%e5%88%87%e9%99%a4%e6%9c%af%e6%82%a3%e8%80%85%e4%bd%bf%e7%94%a8%e6%b0%a8%e7%94%b2%e7%8e%af%e9%85%b8","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=26637","title":{"rendered":"[JAMA\u53d1\u8868\u8bba\u6587]\uff1a\u809d\u810f\u5207\u9664\u672f\u60a3\u8005\u4f7f\u7528\u6c28\u7532\u73af\u9178"},"content":{"rendered":"\n

Original Investigation <\/p>\n\n\n\n

August 19, 2024<\/p>\n\n\n\n

Tranexamic Acid in Patients Undergoing Liver Resection: The HeLiX Randomized Clinical Trial<\/h1>\n\n\n\n

Paul J. Karanicolas, Yulia Lin, Stuart A. McCluskey, et al<\/h3>\n\n\n\n

JAMA. <\/em>Published online August 19, 2024. doi:10.1001\/jama.2024.11783<\/h3>\n\n\n\n

Key Points<\/p>\n\n\n\n

Question<\/strong>  Does tranexamic acid reduce red blood cell transfusion within 7 days of liver resection?<\/p>\n\n\n\n

Findings<\/strong>  In this randomized clinical trial, red blood cell transfusion within 7 days of surgery occurred in 16.3% of participants receiving tranexamic acid and 14.5% receiving placebo. Participants receiving tranexamic acid experienced significantly more complications perioperatively compared with placebo (odds ratio, 1.28; 95% CI, 1.02-1.60; P<\/em>\u2009=\u2009.03).<\/p>\n\n\n\n

Meaning<\/strong>  Among patients undergoing liver resection for a cancer-related indication, tranexamic acid did not reduce bleeding or blood transfusion but increased perioperative complications.<\/a><\/p>\n\n\n\n

Abstract<\/p>\n\n\n\n

Importance<\/strong>  Tranexamic acid reduces bleeding and blood transfusion in many types of surgery, but its effect in patients undergoing liver resection for a cancer-related indication remains unclear.<\/p>\n\n\n\n

Objective<\/strong>  To determine whether tranexamic acid reduces red blood cell transfusion within 7 days of liver resection.<\/p>\n\n\n\n

Design, Setting, and Participants<\/strong>  Multicenter randomized clinical trial of tranexamic acid vs placebo conducted from December 1, 2014, to November 8, 2022, at 10 hepatopancreaticobiliary sites in Canada and 1 site in the United States, with 90-day follow-up. Participants, clinicians, and data collectors were blinded to allocation. A volunteer sample of 1384 patients undergoing liver resection for a cancer-related indication met eligibility criteria and consented to randomization.<\/p>\n\n\n\n

Interventions<\/strong>  Tranexamic acid (1-g bolus followed by 1-g infusion over 8 hours; n\u2009=\u2009619) or matching placebo (n\u2009=\u2009626) beginning at induction of anesthesia.<\/p>\n\n\n\n

Main Outcomes and Measures<\/strong>  The primary outcome was receipt of red blood cell transfusion within 7 days of surgery.<\/p>\n\n\n\n

Results<\/strong>\u00a0\u00a0The primary analysis included 1245 participants (mean age, 63.2 years; 39.8% female; 56.1% with a diagnosis of colorectal liver metastases). Perioperative characteristics were similar between groups. Red blood cell transfusion occurred in 16.3% of participants (n\u2009=\u2009101) in the tranexamic acid group and 14.5% (n\u2009=\u200991) in the placebo group (odds ratio, 1.15 [95% CI, 0.84-1.56];\u00a0P<\/em>\u2009=\u2009.38; absolute difference, 2% [95% CI, \u22122% to 6%]). Measured intraoperative blood loss (tranexamic acid, 817.3 mL; placebo, 836.7 mL;\u00a0P<\/em>\u2009=\u2009.75) and total estimated blood loss over 7 days (tranexamic acid, 1504.0 mL; placebo, 1551.2 mL;\u00a0P<\/em>\u2009=\u2009.38) were similar between groups. Participants receiving tranexamic acid experienced significantly more complications compared with placebo (odds ratio, 1.28 [95% CI, 1.02-1.60];\u00a0P<\/em>\u2009=\u2009.03), with no significant difference in venous thromboembolism (odds ratio, 1.68 [95% CI, 0.95-3.07];\u00a0P<\/em>\u2009=\u2009.08).<\/p>\n\n\n\n

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Conclusions and Relevance<\/strong>  Among patients undergoing liver resection for a cancer-related indication, tranexamic acid did not reduce bleeding or blood transfusion but increased perioperative complications.<\/p>\n\n\n\n

Trial Registration<\/strong>  ClinicalTrials.gov Identifier: NCT02261415<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

Original Investigation  August 19, 2024 […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/26637"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=26637"}],"version-history":[{"count":2,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/26637\/revisions"}],"predecessor-version":[{"id":26901,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/26637\/revisions\/26901"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=26637"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=26637"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=26637"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}