BAR-TAX - Tranexamic Acid in Bariatric Surgery.

Summary

Perioperative bleeding is a relevant complication in bariatric surgery and may lead to hemoglobin decrease, blood transfusions, reinterventions, prolonged hospital stay, and increased healthcare costs. Tranexamic acid (TXA), an antifibrinolytic agent, has demonstrated efficacy in reducing surgical bleeding in several surgical specialties, with a favorable safety profile when appropriately used. However, evidence in bariatric surgery remains limited, particularly considering the intrinsically increased thromboembolic risk of obese patients. The BAR-TAX study is a prospective, single-center study conducted in a high-volume bariatric surgery center, aiming to evaluate the efficacy and safety of perioperative TXA administration compared with standard care without TXA. The primary objective is to assess whether TXA reduces the incidence of clinically significant bleeding within 48-72 hours after bariatric surgery. Secondary objectives include evaluation of hemoglobin drop, transfusion rates, need for hemostatic procedures or reoperation, thromboembolic events, postoperative complications, length of hospital stay, readmissions, and TXA-related adverse events.

Timeline

Start

2025-12-01

Primary completion

2026-06-30

Completion

2026-11-30

Publications

• Background 't Hart JWH, Noordman BJ, Wijnand JMA, Biter LU, Verbrugge SJC, Birnie E, Dunkelgrun M, Huisbrink J, Apers JA. Peroperative administration of tranexamic acid in sleeve gastrectomy to reduce hemorrhage: a double-blind randomized controlled trial. Surg Endosc. 2023 Oct;37(10):7455-7463. doi: 10.1007/s00464-023-10232-5. Epub 2023 Jul 3.
• Background Bieniaszewski K, Proczko-Stepaniak M, Wilczynski M, Nowicki P, Bigda J, Szymanski M. Effectiveness of Tranexamic Acid in Reducing Hidden Blood Loss During Laparoscopic Sleeve Gastrectomy: A Randomized Clinical Trial. J Clin Med. 2025 Apr 26;14(9):3010. doi: 10.3390/jcm14093010.
• Background Lech P, Michalik M, Waczynski K, Osowiecka K, Dowgiallo-Gornowicz N. Effectiveness of prophylactic doses of tranexamic acid in reducing hemorrhagic events in sleeve gastrectomy. Langenbecks Arch Surg. 2022 Nov;407(7):2733-2737. doi: 10.1007/s00423-022-02630-5. Epub 2022 Aug 3.
• Background Brito RM, Oliveira CMB, Moura ECR, Campelo GP, Lima RC, Fe CSM, Sousa TM, Oliveira EJSG, Dibai Filho AV, Leal PDC. Tranexamic acid effects in postoperative bleeding outcomes in laparoscopic sleeve gastrectomy: a controlled study. Acta Cir Bras. 2022 Oct 10;37(7):e370702. doi: 10.1590/acb370702. eCollection 2022.

Drugs

Indications