This is a well-written prospective randomised study (n = 100) on the effect of a single preoperative dose of tranexamic acid on reducing intraoperative blood loss and perioperative transfusions in surgery for advanced ovarian cancer.

The study is well designed despite some unavoidable methodological problems, since this kind of surgery cannot be quite similar due to differences in the extent of the disease. However, it clearly shows that a single dose of tranexamic acid given immediately before surgery significantly reduces bleeding (median total blood loss, 520 vs. 730 mL; P = 0.03) and the need for blood transfusions (red blood cell transfusion rate, 30% vs. 44%; P = 0.02) in this type of major surgery. This result was achieved without an increase in side effects related to prohaemostatic treatment, particularly thromboembolic complications.

The authors correctly conclude that tranexamic acid may be recommended as standard prophylactic treatment in this type of surgery.

– Constantine Vagianos

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