The Role of Tranexamic Acid (TXA) on Postoperative Bleeding in Bariatric Surgery: A Systematic Review and Meta-Analysis

Recent research highlights TXA’s potential in managing postoperative bleeding in bariatric surgery, prompting us to evaluate its effectiveness for treatment and prophylaxis. PubMed, Scopus, Cochrane Central, SciElo, and LILACS were searched for TXA studies in bariatric surgery, excluding those without control groups or with overlapping populations. Outcome analysis focused on postoperative bleeding, length of hospital stay (LOS), TXA side effects, mortality, transfusion needs, and thromboembolic complications. From 93 results, six studies involving 1121 patients were included. TXA use significantly decreased the LOS (MD = − 0.12; 95% CI, − 0.18, − 0.06; p < 0.01), operative time (MD = − 5.77; 95% CI, − 9.98, − 1.56; p < 0.01), and postoperative bleeding (OR = 0.57; 95% CI, 0.34, 0.98; p = 0.043). However, TXA did not affect the rate of hematoma formation (OR = 0.39; 95% CI, 0.07, 2.29; p = 0.299), rate of reoperation (OR = 0.46; 95% CI, 0.08, 2.82; p = 0.403), or need for transfusion (OR = 0.25; 95% CI, 0.06, 1.07; p = 0.062). There were no thromboembolic events or mortality. TXA significantly reduces LOS, operative time, and postoperative bleeding in bariatric surgery without affecting reoperation rates. This medication appears to be safe in this population as it did not increase the risk of thromboembolic events.