Objective: This study aims to investigate the effects of intravenous tranexamic acid (TXA) hemostasis during pediatric hypospadias surgery on postoperative complications.
Materials And Methods: A prospective randomized controlled study was conducted involving patients undergoing transverse preputial island flap urethroplasty (Duckett procedure) for hypospadias between January 2021 and February 2023, who were divided into the TXA group and the control group. Clinical parameters between the two groups were compared, and single-factor and logistic regression analyses were conducted to determine the impact of TXA application on postoperative complications in hypospadias surgery.
Results: A total of 124 hypospadias patients were followed up, with 64 in the TXA group and 60 in the control group. In the TXA group, intraoperative blood loss, electrotome usage, pre- to postoperative change in hemoglobin (ΔHB), and change in hematocrit were significantly lower compared to the control group (p<0.05). Single-factor analysis of postoperative complications showed significant correlations with urethral defect length, electrotome usage, intraoperative blood loss, ΔHB, and bleeding complications after removing the penile bandage (p<0.05). Multivariate logistic regression analysis indicated that TXA application (p=0.049), electrotome usage (p=0.003), intraoperative blood loss (p<0.001), and ΔHB (p=0.001) were independent predictors of postoperative complications.
Conclusion: Intraoperative blood loss and pre- to postoperative change in hemoglobin are independent predictors of complications in the Duckett procedure for hypospadias surgery. Moreover, TXA can reduce blood loss and lower the risk of postoperative complications in patients undergoing the Duckett procedure.
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http://dx.doi.org/10.7759/cureus.72116 | DOI Listing |
Int Urol Nephrol
January 2025
Department of Colorectal Surgery, Heliopolis Hospital, São Paulo, SP, Brazil.
Purpose: Locally advanced colorectal tumors frequently invade adjacent organs, particularly the urinary bladder in the sigmoid colon and upper rectum, complicating multivisceral resections. This study compared postoperative outcomes of partial cystectomy (PC) and total cystectomy (TC) in patients with locally advanced colorectal cancer.
Methods: A systematic review was conducted in PubMed, Scopus, Central Register of Clinical Trials, and Web of Science for studies published up to November 2024.
Arch Orthop Trauma Surg
January 2025
Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway.
Patients with unstable hemodynamics and unstable pelvic ring injuries are still demanding patients regarding initial treatment and survival. Several concepts were reported during the last 30 years. Mechanical stabilization of the pelvis together with hemorrhage control offer the best treatment option in these patients.
View Article and Find Full Text PDFArch Orthop Trauma Surg
January 2025
Department of Orthopedics and Traumatology, University Medical Center Mainz, Mainz, Germany.
Iliosacral screw osteosynthesis is a widely recognized technique for stabilizing unstable posterior pelvic ring injuries, offering notable advantages, including enhanced mechanical stability, minimal invasiveness, reduced blood loss, and lower infection rates. However, the procedure presents technical challenges due to the complex anatomy of the sacrum and the proximity of critical neurovascular structures. While conventional fluoroscopy remains the primary method for intraoperative guidance, precise preoperative planning using multiplanar reconstructions and three-dimensional volume rendering is crucial for ensuring accurate placement of iliosacral or transsacral screws.
View Article and Find Full Text PDFJACC Cardiovasc Imaging
January 2025
Department of Radiology and Imaging Sciences and Krannert Cardiovascular Research Center, Indiana University School of Medicine, Indianapolis, Indiana, USA. Electronic address:
Background: Hemorrhagic myocardial infarction (hMI) can rapidly diminish the benefits of reperfusion therapy and direct the heart toward chronic heart failure. T2∗ cardiac magnetic resonance (CMR) is the reference standard for detecting hMI. However, the lack of clarity around the earliest time point for detection, time-dependent changes in hemorrhage volume, and the optimal methods for detection can limit the development of strategies to manage hMI.
View Article and Find Full Text PDFJACC Cardiovasc Imaging
January 2025
Department of Cardiovascular Medicine, Stanford University, Stanford, California, USA; Department of Radiology, Stanford University, Stanford, California, USA. Electronic address:
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