Investigation the effectiveness of Transamin on percutaneous nephrolithotomy surgery

Background and objective: Percutaneous nephrolithotomy surgery (PCNL) is a common surgery method treatment of staghorn renal stones; however, it may be associated with multiple complications such as bleeding. In our clinical trial study, we investigated the effect of intravenous administration of transamin on reducing bleeding in patients undergoing PCNL surgery.

Method: we started a clinical trial study. A total of 64patients with staghorn renal stone who was admitted to urological unit at Baqiyatallah Hospital for PCNL procedure from 2020 to 2021. Patients were randomly divided into two groups of cases (n=32) and controls (n=32).Patients in case group received intravenous injection of transamin (500 mg) during surgery and then up to 3 doses of 500 mg every 8 hours. After PCNL procedure, parameters such as Hb changes, Hb drop, surgery duration, and hospitalization duration were evaluated and compared between two groups.

Results: 36 patients (56.25%) were male and 28patients (43.75%) were female. There was no significant difference in the mean of age, weight, and the frequency of sex between two groups. No significant difference was observed in the mean of stone size between controls and cases (3.5 ± 0.78 cm vs.3.45 ± 0.87 cm; p=0.69).Patients in the case group revealed lower Hb drop compared to those in control group (0.82 ± 0.4g/dl vs. 2.51 ± 1.03g/dl; p<0.001).The mean of hospitalization time in control group was significantly higher than case group (3.25 ± 0.43 days vs. 3.03 ± 0.17 days; p=0.011).The mean of surgery time was higher in controls than cases (43.12 ± 3.96 min vs. 40.78 ± 3.38 min; p=0.014).

Conclusion: The intravenous injection of tranexamic acid not only decreases Hb drop, but also reduces the hospitalization and PCNL surgery times in patients with staghorn stones without serious side effects.