{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T11:40:20Z","timestamp":1792410020047,"version":"4.4.0"},"reference-count":24,"publisher":"FapUNIFESP (SciELO)","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Cir. Bras."],"abstract":"<jats:p>ABSTRACT  Purpose: Laparoscopic sleeve gastrectomy (LSG) carries a risk of intraoperative and postoperative bleeding. Tranexamic acid (TXA) has been proposed to reduce blood loss. We evaluated the efficacy of TXA in preventing perioperative bleeding in patients undergoing LSG.  Methods: In a randomized clinical trial, 185 morbidly obese patients scheduled for elective LSG were randomly assigned to receive TXA (n = 93) or a placebo (n = 92) before surgery. The rate of bleeding requiring blood transfusion, 24-hour serum hemoglobin levels, postoperative hemodynamic indices, and the incidence of postoperative thrombotic events were assessed.  Results: Intraoperative bleeding occurred less frequently in the TXA group than in the placebo group (1 versus 5.5%, p = 0.012). Postoperative hemoglobin levels were higher in the TXA group (12.5 \u00b1 1.2 g\/dL versus 11.1 \u00b1 1.5 g\/dL, p = 0.002), while transfusion requirements, hemodynamic stability, and length of hospital stay were similar between groups. No postoperative thromboembolic events were observed. Multivariable analysis confirmed TXA as an independent predictor of reduced bleeding and higher postoperative hemoglobin levels.  Conclusion: TXA significantly reduced intraoperative bleeding and improved postoperative hemoglobin levels in LSG without increasing hemodynamic instability or the risk of thromboembolic events.<\/jats:p>","DOI":"10.1590\/acb416226","type":"journal-article","created":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T10:47:28Z","timestamp":1792406848000},"source":"Crossref","is-referenced-by-count":0,"title":["Tranexamic acid in laparoscopic sleeve gastrectomy: bleeding control amid thrombotic concerns and hemodynamic instability: a randomized double-blinded clinical trial"],"prefix":"10.1590","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9698-5080","authenticated-orcid":false,"given":"Osman An\u0131l","family":"Sava\u015f","sequence":"first","affiliation":[{"name":"Okan University","place":["Istanbul, Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6063-4422","authenticated-orcid":false,"given":"Sel\u00e7uk","family":"Mercan","sequence":"additional","affiliation":[{"name":"Okan University","place":["Istanbul, Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-5448-1289","authenticated-orcid":false,"given":"Amir Mahdi","family":"Akbari","sequence":"additional","affiliation":[{"name":"Okan University","place":["Istanbul, Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5957-5277","authenticated-orcid":false,"given":"Mehrdad","family":"Sheikhvatan","sequence":"additional","affiliation":[{"name":"Okan University","place":["Istanbul, Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","published-online":{"date-parts":[[2026]]},"reference":[{"issue":"6","key":"ref1","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1007\/s00134-019-05594-1","article-title":"Obesity in the critically ill: a narrative review","volume":"45","author":"Schetz M","year":"2019","journal-title":"Intensive Care Med"},{"issue":"1","key":"ref2","first-page":"3","article-title":"Obesity, adipose tissue, and bariatric surgery","volume":"77","author":"Frigolet ME","year":"2020","journal-title":"Bol Med Hosp Infant Mex"},{"issue":"4","key":"ref3","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1007\/s13679-021-00453-x","article-title":"Sex\/gender differences in obesity prevalence, comorbidities, and treatment","volume":"10","author":"Cooper AJ","year":"2021","journal-title":"Curr Obes 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laparoscopic sleeve gastrectomy","volume":"13","author":"Belluzzi A","year":"2024","journal-title":"J Clin Med"},{"issue":"2","key":"ref8","doi-asserted-by":"crossref","DOI":"10.1016\/j.heliyon.2020.e03496","article-title":"The advantages and disadvantages of sleeve gastrectomy; clinical laboratory to bedside review","volume":"6","author":"Kheirvari M","year":"2020","journal-title":"Heliyon"},{"issue":"2","key":"ref9","article-title":"The role of tranexamic acid in sleeve gastrectomy: a systematic review and meta-analysis","volume":"16","author":"Al-Juhani A","year":"2024","journal-title":"Cureus"},{"issue":"3","key":"ref10","doi-asserted-by":"crossref","first-page":"1200","DOI":"10.1007\/s11695-026-08496-6","article-title":"Efficacy and safety of tranexamic acid in sleeve gastrectomy: a double-blind randomized controlled trial","volume":"36","author":"Nageeb ME","year":"2026","journal-title":"Obes 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preoperative administration of tranexamic acid in sleeve gastrectomy (PATAS) to reduce haemorrhage rates","volume":"10","author":"Leeman M","year":"2020","journal-title":"BMJ Open"},{"issue":"1","key":"ref18","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1186\/s12893-025-03442-2","article-title":"Efficacy and safety of tranexamic acid during bariatric surgery: an updated systematic review and meta-analysis of 10 comparative studies","volume":"26","author":"Abu-Zaid A","year":"2025","journal-title":"BMC Surg"},{"issue":"7","key":"ref19","doi-asserted-by":"crossref","DOI":"10.1590\/acb370702","article-title":"Tranexamic acid effects in postoperative bleeding outcomes in laparoscopic sleeve gastrectomy: a controlled study","volume":"37","author":"Brito RM","year":"2022","journal-title":"Acta Cir Bras"},{"issue":"5","key":"ref20","doi-asserted-by":"crossref","first-page":"1571","DOI":"10.1007\/s11695-023-06563-w","article-title":"Role of tranexamic acid (TXA) in preventing bleeding following sleeve gastrectomy: a systematic review and meta-analysis","volume":"33","author":"Mocanu V","year":"2023","journal-title":"Obes Surg"},{"issue":"5","key":"ref21","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1016\/j.soard.2013.05.007","article-title":"Laparoscopic sleeve gastrectomy compared with other bariatric surgical procedures: a systematic review of randomized trials","volume":"9","author":"Trastulli S","year":"2013","journal-title":"Surg Obes Relat Dis"},{"issue":"5","key":"ref22","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1177\/15533506251344055","article-title":"The effect of prophylactic intraoperative tranexamic acid use on bleeding after laparoscopic sleeve gastrectomy with omentopexy: a prospective cohort study","volume":"32","author":"Dalk\u0131l\u0131\u00e7 MS","year":"2025","journal-title":"Surg Innov"},{"issue":"2","key":"ref23","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1007\/s11695-023-07021-3","article-title":"Intra-operative tranexamic acid administration significantly decreases incidence of postoperative bleeding without increasing venous thromboembolism risk after laparoscopic sleeve gastrectomy: a retrospective cohort study of over 400 patients","volume":"34","author":"Hossain N","year":"2024","journal-title":"Obes Surg"},{"issue":"9","key":"ref24","doi-asserted-by":"crossref","first-page":"3010","DOI":"10.3390\/jcm14093010","article-title":"Effectiveness of tranexamic acid in reducing hidden blood loss during laparoscopic sleeve gastrectomy: a randomized clinical trial","volume":"14","author":"Bieniaszewski K","year":"2025","journal-title":"J Clin Med"}],"container-title":["Acta Cir\u00fargica 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