# Effect of tranexamic acid irrigation on perioperative blood loss during mini‐percutaneous nephrolithotomy: A pilot double‐blind randomised controlled trial

## TL;DR

Adding tranexamic acid to irrigation fluid during a kidney stone procedure reduced blood loss and was safe in a small trial.

## Contribution

This pilot study demonstrates that tranexamic acid in irrigation fluid reduces blood loss during mini-PCNL without adverse effects.

## Key findings

- TXA group had significantly less hemoglobin decline and estimated blood loss compared to placebo.
- Operative time and hospital stay were shorter in the TXA group.
- No TXA-related adverse events were observed.

## Abstract

To evaluate the efficacy and safety of adding 0.1% tranexamic acid (TXA) to irrigation fluid in reducing perioperative blood loss during mini‐percutaneous nephrolithotomy (mini‐PCNL).

In this prospective, randomised study, 40 patients undergoing mini‐PCNL were allocated to receive irrigation fluid containing either 0.1% TXA (n = 20) or distilled water (placebo; n = 20). The outcomes assessed included changes in haemoglobin, estimated blood loss, operative duration, irrigation volume, length of hospital stay, transfusion requirements, stone clearance and TXA‐related adverse events.

Baseline characteristics were comparable between the two groups. The TXA group had significantly less haemoglobin decline (0.5 g/dl vs. 1.5 g/dl) and lower estimated blood loss (91.7 ml vs. 169.0 ml) compared with the placebo group (both p < 0.05). Operative time and hospital stay were also shorter in the TXA group (p < 0.05). Transfusion rate and irrigation volume were lower in the TXA group, while stone clearance rates were comparable between the groups (90% vs. 85%; p = 0.633). No TXA‐related adverse events were observed.

The addition of 0.1% TXA to irrigation fluid during mini‐PCNL significantly reduces perioperative blood loss and appears to be safe in this pilot cohort, without increasing complications observed in the study.