{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T20:04:10Z","timestamp":1784145850107,"version":"3.55.0"},"reference-count":22,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T00:00:00Z","timestamp":1774224000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T00:00:00Z","timestamp":1774224000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Objectives<\/jats:title>\n                    <jats:p>Hemorrhage after oncologic breast surgery occurs in up to 11% of cases, remaining the leading cause of reoperation. Although antifibrinolytics are widely used in other surgical settings, their role in oncologic breast surgery is not well established. This study evaluated the efficacy and safety of aminocaproic acid (ACAc) in reducing postoperative hematoma following oncological mastectomies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A prospective randomized study was conducted between July 2020 and May 2022, including women \u2265\u200918 years old undergoing mastectomy. Patients were randomized into three groups: (A) topical application of 5\u2009g of ACAc; (B) intravenous 2.5\u2009g administered 30\u2009min before incision; and (C) no treatment (control). Statistical tests included ANOVA, Chi\u2010square, and multivariable regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 166 patients were enrolled. Postoperative hematoma occurred in 3.6% of patients in group A, 1.8% patients in group B, and 12.7% in the control. Multivariable logistic regression demonstrated a protective effect of intravenous ACAc compared with control (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.021). No differences in reoperation rates were observed. No thromboembolic events nor hepatic or renal toxicity occurred. Hypertension was identified as an independent risk factor for postoperative hematoma.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Intravenous ACAc reduces postoperative hematoma in oncologic mastectomy and may represent a low\u2010cost, effective adjunct to bleeding prevention in this setting.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jso.70244","type":"journal-article","created":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T04:17:14Z","timestamp":1774325834000},"page":"863-871","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy of Aminocaproic Acid in Preventing Postoperative Hematoma in Breast Cancer Surgery: A Prospective Study"],"prefix":"10.1002","volume":"133","author":[{"given":"Teresa Vieira","family":"Caro\u00e7o","sequence":"first","affiliation":[{"name":"General Surgery Department Instituto Portugu\u00eas de Oncologia de Coimbra Francisco Gentil EPE Coimbra Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u00e3o","family":"Reis","sequence":"additional","affiliation":[{"name":"Mathematics Department Universidade de Aveiro Aveiro Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raquel Prata","family":"Saraiva","sequence":"additional","affiliation":[{"name":"General Surgery Department Instituto Portugu\u00eas de Oncologia de Coimbra Francisco Gentil EPE Coimbra Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel Duarte","family":"\u00c2ngelo","sequence":"additional","affiliation":[{"name":"General Surgery Department Instituto Portugu\u00eas de Oncologia de Coimbra Francisco Gentil EPE Coimbra Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Miguel","family":"Bai\u00e3o","sequence":"additional","affiliation":[{"name":"General Surgery Department Instituto Portugu\u00eas de Oncologia de Coimbra Francisco Gentil EPE Coimbra Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuela","family":"Romano","sequence":"additional","affiliation":[{"name":"General Surgery Department Instituto Portugu\u00eas de Oncologia de Coimbra Francisco Gentil EPE Coimbra Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Concei\u00e7\u00e3o","family":"Silva","sequence":"additional","affiliation":[{"name":"General Surgery Department Instituto Portugu\u00eas de Oncologia de Coimbra Francisco Gentil EPE Coimbra Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anabela","family":"Costa","sequence":"additional","affiliation":[{"name":"General Surgery Department Instituto Portugu\u00eas de Oncologia de Coimbra Francisco Gentil EPE Coimbra Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel Cristina","family":"Ferr\u00e3o","sequence":"additional","affiliation":[{"name":"General Surgery Department Instituto Portugu\u00eas de Oncologia de Coimbra Francisco Gentil EPE Coimbra Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,23]]},"reference":[{"key":"e_1_2_9_2_1","volume-title":"Breast Cancer [Internet]","year":"2021"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdz173"},{"key":"e_1_2_9_4_1","unstructured":"Guidelines\u00ae NNCCN National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology \u2010 Breast Cancer [Internet] https:\/\/www.nccn.org\/guidelines\/category_1#breast."},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1345\/aph.1Q383"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.suc.2021.06.014"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.10592"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2015.01.054"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2012.02.184"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.4103\/0259-1162.103378"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2021.08.113"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.12910"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.4103\/aca.ACA_137_18"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0039-1696722"},{"issue":"7","key":"e_1_2_9_15_1","first-page":"7978","article-title":"Epsilon Aminocaproic Acid Reduces Blood Transfusion and Improves the Coagulation Test After Pediatric Open\u2010Heart Surgery: A Meta\u2010Analysis of 5 Clinical Trials","volume":"8","author":"Lu J.","year":"2015","journal-title":"International Journal of Clinical and Experimental Pathology"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.26142"},{"issue":"4","key":"e_1_2_9_17_1","first-page":"764","article-title":"Utility of Tranexamic Acid to Minimize Blood Loss in Brain Tumour Surgery","volume":"70","author":"Bukhari S. 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