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Innovation of minimally Invasive Procedures in Urology
Balík, Michal ; Pacovský, Jaroslav (advisor) ; Študent, Vladimír (referee) ; Záleský, Miroslav (referee)
Innovation of minimally invasive procedures in urology MUDr. Michal Balík Abstract Background Prophylactic administration of tranexamic acid reduces blood loss in procedures with a high risk of perioperative bleeding. There is good evidence for this published in cardiac surgery, orthopedics, and gynecology. However, in urology, papers have been published so far with ambivalent results in transurethral resection of the prostate, open radical prostatectomy, or radical cystectomy. No study to date has tested prophylactic administration of tranexamic acid at the beginning of robotic-assisted radical prostatectomy. Methods Based on the promising results of a pilot study that evaluated the effect of prophylactic tranexamic acid administration during robot-assisted radical prostatectomy on perioperative blood loss and the incidence and severity of complications, we performed the RARPEX study - a prospective, double-blind, randomized, placebo-controlled trial. Our aim was to confirm preliminary data in a sufficient cohort of patients with multiple surgeons. Results In the RARPEX study, we demonstrated a positive effect of prophylactic tranexamic acid administration during robotic-assisted radical prostatectomy on hemoglobin decline in all measurements. However, the difference between the groups did not reach the...
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