Mp67-12 Pre-Procedure Tranexamic Acid for Novel Insights: Influence on Perinephric Hematoma Incidence and Hospitalization Duration in Renal Cryoablation

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy V (MP67)1 May 2024MP67-12 PRE-PROCEDURE TRANEXAMIC ACID FOR NOVEL INSIGHTS: INFLUENCE ON PERINEPHRIC HEMATOMA INCIDENCE AND HOSPITALIZATION DURATION IN RENAL CRYOABLATION Marc McCoy, Shaine Jivan, Steven Lu, Evan Allarie, Zachary Valley, Summit Kawakami, Richard Cormack, Henry Walton, Michael Welsh, Bryan Donnelly, and Kamaljot S. Kaler Marc McCoyMarc McCoy , Shaine JivanShaine Jivan , Steven LuSteven Lu , Evan AllarieEvan Allarie , Zachary ValleyZachary Valley , Summit KawakamiSummit Kawakami , Richard CormackRichard Cormack , Henry WaltonHenry Walton , Michael WelshMichael Welsh , Bryan DonnellyBryan Donnelly , and Kamaljot S. KalerKamaljot S. Kaler View All Author Informationhttps://doi.org/10.1097/01.JU.0001009496.54470.10.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Percutaneous renal cryoablation (PCA) is a minimally invasive alternative treatment for small renal masses. Prior research has investigated the use of tranexamic acid (TXA) in diverse urologic procedures, yet there is a no evidence regarding its application in PCA. This study assesses the efficacy of pre-operative TXA in reducing post-operative perinephric hematoma formation. METHODS: Patients who underwent PCA of renal masses from June 2020 to June 2023 were analyzed. Cryoprobe placement and ice-ball formation were monitored via computed tomography (CT) imaging intraoperatively. Perinephric hematoma status was determined upon review of CT imaging performed at the end of the treatment. Pre-operative IV TXA was regularly administered commencing August 2021. AIC minimized generalized linear models with a logit link function were developed for the primary outcome of post-procedural perinephric hematoma and secondary outcome of same-day discharge. A Fisher's Exact Test was used to compare TXA and non-TXA groups. RESULTS: This study included 223 patients (TXA; n=118, non-TXA; n=105) with a median age of 65.8 years and median follow-up of 15 months. There were relatively fewer post-operative perinephric hematomas in the TXA group (27.1%) relative to the non-TXA group (39.1%) (Table 1). TXA administration was associated with an OR of 0.54 95% CI, 0.29–1.01; p-value = 0.055 when analyzing post-operative perinephric hematoma. Same day discharge incidence was higher in the TXA group (88.1%) relative to the non-TXA group (76.2%). TXA was associated with an OR of 2.80 95% CI, 1.25–6.26; p-value = 0.013 when analyzing same day discharge (Figure 1). The Clavien-Dindo 3+ complication rate was 1.8%, overall local recurrence rate was 0.0%, and residual disease rate was 3.1% for the aggregate cohort. CONCLUSIONS: This study provides novel evidence for the administration of pre-operative TXA in reducing perinephric hematoma post PCA, as well as increasing the likelihood of same day discharge. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1102 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Marc McCoy More articles by this author Shaine Jivan More articles by this author Steven Lu More articles by this author Evan Allarie More articles by this author Zachary Valley More articles by this author Summit Kawakami More articles by this author Richard Cormack More articles by this author Henry Walton More articles by this author Michael Welsh More articles by this author Bryan Donnelly More articles by this author Kamaljot S. Kaler More articles by this author Expand All Advertisement PDF downloadLoading ...