The effect of tranexamic acid use on the amount of bleeding in perioperative and postoperative periods in patients in undergoing open abdominal myomectomy, Hacettepe University Faculty of Medicine

Uterine fibroids (leiomyomas or myomas) are the most common pelvic tumors in women. Open abdominal (laparotomic) myomectomy is one of surgical methods used in the treatment for fibroids. During last years, several studies have looked into the effectiveness of tranexamic acid use for various indications. Tranexamic acid is a synthetic antifibrinolytic and an easily accessible and applicable treatment option for prevention and treatment of hemorrhage, which is one of the most common and complications of myomectomy. Our study aimed to investigate the effect of perioperative and postoperative application of tranexamic acid on amount of bleeding in patients undergoing laparotomic myomectomy. In our retrospective analysis, we included 108 patients, who underwent laparotomic myomectomy in Hacettepe University Faculty of Medicine, Department of Gynecology and Obstetrics between July 2018 and June 2022. 36 patients received tranexamic acid intravenously according to institutional protocol. 72 patients in the control group weren't treated with any kind of antifibrinolytic treatment. Age and total volume of excised fibroids were similar in both groups. There was no significant difference in the perioperative decline of hemoglobin, hematocrit and platelet values. This data indicates that no significant reduction in bleeding was achieved with use of intra- and postoperative intravenous tranexamic acid in patients undergoing laparotomic myomectomy. Randomized controlled studies with larger sample sizes and different infusions protocols are warranted for further evidence on the use of tranexamic acid for reduction of bleeding in myomectomy. Key words: tranexamic acid, myomectomy, bleeding, hemoglobin, hematocrit