Does Topical Tranexamic Acid Facilitate Faster Discharge Following Lung Resection? A Retrospective Cohort Analysis

Area of Science:

• Thoracic Surgery
• Surgical Hemostasis
• Pharmacology

Background:

• Postoperative drainage and prolonged hospital stays are challenges in thoracic surgery.
• Systemic antifibrinolytics pose risks like neurotoxicity and thromboembolism.
• Topical tranexamic acid (t-TXA) lavage offers a localized approach to manage hyperfibrinolysis.

Purpose of the Study:

• To evaluate the efficacy and safety of a high-volume t-TXA lavage protocol.
• To assess its impact on postoperative drainage and length of hospital stay.
• To explore its potential as an adjuvant in major lung resections.

Main Methods:

• Retrospective comparative study of 52 patients undergoing major lung resection.
• t-TXA group (n=26) received 5g TXA in 500mL saline lavage.
• Control group (n=26) received saline lavage; outcomes included POD 1 drainage and LOS.

Main Results:

• The t-TXA group had a significantly shorter length of stay (4.20 vs 5.88 days, p=0.001).
• POD 1 drainage was numerically lower in the t-TXA group (189 vs 284 mL, p=0.101) with a significant negative correlation (r=-0.412, p=0.002).
• Postoperative platelet counts were lower in the t-TXA group (p=0.009); no adverse events occurred in 1-year follow-up.

Conclusions:

• High-volume t-TXA lavage is a promising adjuvant for thoracic surgery.
• It is associated with significantly shorter hospital stays and a trend toward reduced drainage.
• Prospective trials are needed to confirm safety and clinical utility due to the study's exploratory nature.