{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T06:19:17Z","timestamp":1774937957125,"version":"3.50.1"},"reference-count":46,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,8,29]],"date-time":"2024-08-29T00:00:00Z","timestamp":1724889600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Cranial meningioma surgeries often involve significant blood loss and transfusions. Tranexamic acid (TXA) has been used to reduce blood loss in various surgeries. This meta-analysis of randomized placebo-controlled trials (RCTs) evaluates the impact of TXA in cranial meningioma surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Pubmed, Web of Science, and Cochrane Library were searched for RCTs. Studies were compared for: Blood loss, operative time, hospital stay, reoperation rates, allogeneic and autologous transfusion, and incidence of complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seven RCTs with 490 patients receiving TXA and 491 receiving placebos were included. TXA significantly shortened operative time (Mean Difference (MD): -20.95; 95%CI: -39.94 to -1.95; p=0.03). Blood loss was lower with TXA (MD: -262.7 ml; 95%CI: -397.6 to -127.8; p=0.0001). Odds of reoperation were not significantly different (OR: 0.44; 95%CI: 0.13-1.45; p=0.18). TXA significantly reduced the need for RBC transfusions (OR: 0.47; 95%CI: 0.22-0.99; p&amp;lt;0.05). No significant differences were observed regarding postoperative seizures (OR: 1.06; 95%CI: 0.56-2.03; p=0.85), hydrocephalus (OR: 0.25; 95%CI: 0.03-2.29; p=0.22), or hematoma (OR: 0.52; 95%CI: 0.22-1.28; p=0.16). Hospital stay was shortened in the TXA group (MD: -1.23; 95%CI: -2.41 to -0.05; p=0.04).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This meta-analysis suggests that a single intraoperative dose of TXA reduces blood loss, allogeneic blood transfusions and shortens surgery time.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fonc.2024.1464671","type":"journal-article","created":{"date-parts":[[2024,8,29]],"date-time":"2024-08-29T04:11:02Z","timestamp":1724904662000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Intraoperative tranexamic acid administration in cranial meningioma surgery: a meta-analysis of prospective randomized, double-blinded, and placebo-controlled trials"],"prefix":"10.3389","volume":"14","author":[{"given":"Martin","family":"Vychopen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felix","family":"Arlt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erdem","family":"G\u00fcresir","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johannes","family":"Wach","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2024,8,29]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1002\/rth2.12546","article-title":"Tranexamic acid evidence and controversies: An illustrated review","volume":"5","author":"Relke","year":"2021","journal-title":"Res Pract Thromb Haemost"},{"key":"B2","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1111\/ejh.13348","article-title":"The many roles of tranexamic acid: An overview of the clinical indications for TXA in medical and surgical patients","volume":"104","author":"Cai","year":"2020","journal-title":"Eur J Hematol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1186\/1745-6215-11-40","article-title":"The WOMAN Trial (World Maternal Antifibrinolytic Trial): tranexamic acid for the treatment of postpartum hemorrhage: an international randomized, double blind placebo controlled trial","volume":"11","author":"Shakur","year":"2010","journal-title":"Trials"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3310\/hta17100","article-title":"The CRASH-2 trial: a randomized controlled trial and economic evaluation of the effects of tranexamic acid on death, vascular occlusive events and transfusion requirement in bleeding trauma patients","volume":"17","author":"Roberts","year":"2013","journal-title":"Health Technol Assess"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1055\/s-0039-3399487","article-title":"Effect of intraoperative blood loss on perioperative complications and neurological outcome in adult patients undergoing elective brain tumor surgery","volume":"10","author":"Rajagopalan","year":"2019","journal-title":"J Neurosci Rural Pract"},{"key":"B6","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1186\/s12885-019-5271-7","article-title":"A comprehensive study of risk factors for post-operative pneumonia following resection of meningioma","volume":"19","author":"Zuo","year":"2019","journal-title":"BMC Cancer"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines9030319","article-title":"Meningioma: A review of epidemiology, pathology, diagnosis, treatment, and future directions","volume":"9","author":"Ogasawara","year":"2021","journal-title":"Biomedicines"},{"key":"B8","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1016\/j.jocn.2023.01.012","article-title":"Tranexamic acid use in meningioma surgery - A systematic review and meta-analysis","volume":"110","author":"Clynch","year":"2023","journal-title":"J Clin Neurosci"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e318283c83a","article-title":"A practical tranexamic acid dosing scheme based on population pharmacokinetics in children undergoing cardiac surgery","volume":"118","author":"Grassin-Delyle","year":"2013","journal-title":"Anesthesiology"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000006039","article-title":"Update on applications and limitations of perioperative tranexamic acid","volume":"135","author":"Patel","year":"2022","journal-title":"Anesth Analg"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000003637","article-title":"Optimal tranexamic acid dosing regimen in cardiac surgery: what are the missing pieces","volume":"134","author":"Faraoni","year":"2021","journal-title":"Anesthesiology"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1007\/s11060-018-2941-2","article-title":"Postoperative seizures in meningioma patients: improving patient selection for antiepileptic drug therapy","volume":"140","author":"Islim","year":"2018","journal-title":"J Neurooncol"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"B14","unstructured":"Cochrane Handbook for Systematic Reviews of Interventions version 6.4 (updated August 2023). Cochrane\n          \n          \n            \n              Higgins\n              JPT\n            \n            \n              Thomas\n              J\n            \n            \n              Chandler\n              J\n            \n          \n          \n          2023"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6947-7-16","article-title":"Utilization of the PICO framework to improve searching PubMed for clinical questions","volume":"7","author":"Schardt","year":"2007","journal-title":"BMC Med Inform Decis Mak"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1089\/neu.1998.15.573","article-title":"Structured interviews for the Glasgow Outcome Scale and the extended Glasgow Outcome Scale: guidelines for their use","volume":"15","author":"Wilson","year":"1998","journal-title":"J\u00a0Neurotrauma"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1186\/s40779-020-00238-8","article-title":"Methodological quality (risk of bias) assessment tools for primary and secondary medical studies: what are they and which is better","volume":"7","author":"Ma","year":"2020","journal-title":"Mil Med Res"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7414.557","article-title":"Measuring inconsistency in meta-analyses","volume":"327","author":"Higgins","year":"2003","journal-title":"BMJ"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2017.02.053","article-title":"Effect of tranexamic acid on intraoperative blood loss and transfusion requirements in patients undergoing excision of intracranial meningioma","volume":"41","author":"Hooda","year":"2017","journal-title":"J Clin Neurosci"},{"key":"B20","article-title":"Use of tranexamic acid to reduce intraoperative bleeding in craniotomy for meningioma patients","volume":"85","author":"Siddiqui","year":"2018","journal-title":"Asian Arch Anesthesiol Resusc"},{"key":"B21","doi-asserted-by":"publisher","first-page":"8","DOI":"10.24244\/jni.vol8i1.200","article-title":"Effects of intravenous tranexamic acid on blood loss and transfusion requirements in tumor removal surgery of suspected meningioma","volume":"8","author":"Sutanto","year":"2019","journal-title":"J Neuroanestesi Indones"},{"key":"B22","doi-asserted-by":"publisher","first-page":"272","DOI":"10.25259\/SNI_296_2021","article-title":"Effect of tranexamic acid on blood loss, coagulation profile, and quality of surgical field in intracranial meningioma resection: A prospective randomized, double-blind, placebo-controlled study","volume":"12","author":"Ravi","year":"2021","journal-title":"Surg Neurol Int"},{"key":"B23","doi-asserted-by":"publisher","first-page":"289","DOI":"10.25259\/SNI_177_2021","article-title":"Intraoperative tranexamic acid use in patients undergoing excision of intracranial meningioma: Randomized, placebo-controlled trial","volume":"12","author":"Rebai","year":"2021","journal-title":"Surg Neurol Int"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.36552\/pjns.v26i4.822","article-title":"A comparison of the use of tranexamic acid versus placebo in patients undergoing excision of intracranial meningioma","volume":"26","author":"Khalid","year":"2023","journal-title":"Pak J Neurol Surg"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2023.111285","article-title":"Intravenous tranexamic acid for intracerebral meningioma resections: A randomized, parallel-group, non-inferiority trial","volume":"92","author":"Li","year":"2024","journal-title":"J Clin Anesth"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0291171","article-title":"Risk factors for intraoperative blood loss in resection of intracranial meningioma: Analysis of 530 cases","volume":"18","author":"Wang","year":"2023","journal-title":"PloS One"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.32598\/bcn.9.10.370","article-title":"Investigating effective factors on estimated hemorrhage intraoperative in brain meningioma surgery","volume":"11","author":"Tabibkhooei","year":"2020","journal-title":"Basic Clin Neurosci"},{"key":"B28","article-title":"Correlation between preoperative imaging features and intraoperative blood loss of meningioma: a new scoring system for predicting intraoperative blood loss","volume":"57","author":"L\u00fc","year":"2013","journal-title":"J Neurosurg Sci"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.3171\/2021.1.SPINE201935","article-title":"Influence of tranexamic acid use on venous thromboembolism risk in patients undergoing surgery for spine tumors","volume":"35","author":"Pennington","year":"2021","journal-title":"J Neurosurg Spine"},{"key":"B30","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1016\/j.ejphar.2017.10.001","article-title":"Tranexamic acid impairs hippocampal synaptic transmission mediated by gamma aminobutyric acid receptor type A","volume":"815","author":"Irl","year":"2017","journal-title":"Eur J Pharmacol"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2024.1388138","article-title":"Safety assessment of tranexamic acid: real-world adverse event analysis from the FAERS database","volume":"15","author":"Tian","year":"2024","journal-title":"Front Pharmacol"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.3390\/cancers14041033","article-title":"Proliferative potential, and inflammatory tumor microenvironment in meningioma correlate with neurological function at presentation and anatomical location-from convexity to skull base and spine","volume":"14","author":"Wach","year":"2022","journal-title":"Cancers (Basel)"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1007\/s10143-018-0976-7","article-title":"Meningiomas: skull base versus non-skull base","volume":"42","author":"Meling","year":"2019","journal-title":"Neurosurg Rev"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.3171\/2018.1.JNS172724","article-title":"The Meningioma Vascularity Index: a volumetric analysis of flow voids to predict intraoperative blood loss in nonembolized meningiomas","volume":"130","author":"Lagman","year":"2018","journal-title":"J Neurosurg"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1007\/s00062-023-01272-4","article-title":"Preoperative embolization of meningiomas facilitates reduced surgical complications and improved clinical outcomes: A meta-analysis of matched cohort studies","volume":"33","author":"Schartz","year":"2023","journal-title":"Clin Neuroradiol"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.3171\/2015.8.JNS151211","article-title":"Utility of arterial spin labeling perfusion magnetic resonance imaging in prediction of angiographic vascularity of meningiomas","volume":"125","author":"Yoo","year":"2016","journal-title":"J Neurosurg"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000009552","article-title":"Efficacy and safety of tranexamic acid in total hip replacement: a PRISMA- compliant meta-analysis of 25 randomized controlled trials","volume":"96","author":"Zhu","year":"2017","journal-title":"Med (Baltimore)"},{"key":"B38","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1186\/s13018-017-0660-6","article-title":"The efficacy of tranexamic acid using oral administration in total knee arthroplasty: a systematic review and meta-analysis","volume":"12","author":"Zhang","year":"2017","journal-title":"J Orthop Surg Res"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijom.2018.07.027","article-title":"The efficacy of tranexamic acid for orthognathic surgery: a meta-analysis of randomized controlled trials","volume":"48","author":"Mei","year":"2019","journal-title":"Int J Oral Maxillofac Surg"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD004328.pub3","article-title":"Tranexamic acid for patients with nasal hemorrhage (epistaxis)","volume":"12","author":"Joseph","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2022.07.044","article-title":"Is tranexamic acid beneficial in open spine surgery? and its effects vary by dosage, age, sites, and locations: a meta-analysis of randomized controlled trials","volume":"166","author":"Liu","year":"2022","journal-title":"World Neurosurg"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2012.05.002","article-title":"Tranexamic acid reduces blood loss and financial cost in primary total hip and knee replacement surgery","volume":"98","author":"Irisson","year":"2012","journal-title":"Orthop Traumatol Surg Res"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2021.12.117","article-title":"Use of tranexamic acid for elective resection of intracranial neoplasms: A systematic review","volume":"160","author":"Brown","year":"2022","journal-title":"World Neurosurg"},{"key":"B44","doi-asserted-by":"publisher","first-page":"1893","DOI":"10.1056\/NEJMc1703369","article-title":"Tranexamic acid in patients undergoing coronary-artery surgery","volume":"376","author":"Myles","year":"2017","journal-title":"N Engl J Med"},{"key":"B45","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1186\/s12874-015-0024-z","article-title":"The heterogeneity statistic I(2) can be biased in small meta-analyses","volume":"15","author":"Von Hippel","year":"2015","journal-title":"BMC Med Res Methodol"},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000001596","article-title":"Publication bias: the elephant in the review","volume":"123","author":"Dalton","year":"2016","journal-title":"Anesth Analg"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2024.1464671\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,29]],"date-time":"2024-08-29T04:11:07Z","timestamp":1724904667000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2024.1464671\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,29]]},"references-count":46,"alternative-id":["10.3389\/fonc.2024.1464671"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2024.1464671","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,29]]},"article-number":"1464671"}}