Objective:

Assess the feasibility of implementing a standardized three-dose intravenous tranexamic acid (TXA) regimen in routine metabolic bariatric surgery, with exploratory assessment of clinical outcomes.

Approach:

• Design and setting: Prospective cohort investigation at one academic center from September 2023 to August 2024, using alternating three-month TXA and non-TXA periods.
• Participants: Of 1,122 screened patients, 1,077 adults without absolute TXA contraindications were included; procedures were sleeve gastrectomy, Roux-en-Y gastric bypass, or revisional surgery.
• Intervention: The TXA regimen was three intravenous 1-g doses at anesthesia induction, the evening of surgery, and the following morning. Both groups received standardized thromboprophylaxis.
• Outcomes: Primary feasibility measures were recruitment, intervention and dosing adherence, and completeness of 30-day follow-up. Exploratory outcomes included clinically significant bleeding, operative time, length of stay, and thromboembolic events.

Key Findings:

• The provided context reports that 1,077 patients were included: 549 in TXA periods and 528 in non-TXA periods. It does not include feasibility results or comparative clinical outcome findings.

Interpretation:

The investigation was designed primarily to assess implementation feasibility; clinical outcomes were exploratory.

Limitations:

• The study was conducted at a single academic institution.
• Treatment allocation followed alternating calendar periods rather than individual randomization.
• The sample size reflected institutional surgical volume and was not calculated for efficacy.

Sources:

• Article context provided in the prompt