The use of tranexamic acid for the prevention of hemorrhagic complications in percutaneous nephrolithotripsy. Literature review

Introduction. The problem of urolithiasis remains relevant throughout the world. The widespread prevalence of the disease is the reason for the search for new and effective methods of dealing with various complications of surgical treatment in order to improve the efficiency of patient treatment. Materials and methods. The material was searched in the following databases: PubMed, Google Scholar, Scopus by keywords such as «Tranexamic acid and percutaneous nephrolithotripsy». When searching in the above databases, 18 articles were found and analyzed. The results of preoperative, intra - and postoperative use of tranexamic acid (TA) in various dosages, and the frequency of the drug use, including the addition of TA to the irrigation fluid, are described. Indicators such as the average level of hemoglobin, the time of surgery, the need for blood transfusion, and the volume of irrigation fluid were evaluated. In all these cases, the control group consisted of patients for whom TA was not used either before the operation or in the postoperative period. Results. The article presents an analysis of the literature data on the correction of hemorrhagic complications by the use of TA. The data on intra- and postoperative hemorrhagic complications of percutaneous nephrolithotripsy (PNLT) and the effect of TA on them are presented. The results of preoperative, intra- and postoperative use of TA in various dosages, and the frequency of use of the drug, including the addition of TA to the irrigation fluid, are described. Indicators such as the average hemoglobin level, operation time, the need for blood transfusion, and the volume of irrigation fluid were assessed. In all the above cases, the control group consisted of patients in whom TA was not used either before the operation or in the postoperative period. Conclusions. The results obtained make it possible to judge the safety and appropriateness of the use of TA in order to reduce the degree of hemorrhagic complications both during the operation and in the postoperative period. Assessment of the hemostatic system and the effect of hemostatic drugs during the surgical treatment of urolithiasis on the upper urinary tract, in our opinion, is a key moment in improving the effectiveness of patient treatment.