Abdominal Neoplasms ; diagnosis ; surgery ; Aged ; Diagnosis, Differential ; Hernia, Inguinal ; diagnosis ; Humans ; Inguinal Canal ; pathology ; Lymphangioma ; diagnosis ; surgery ; Male ; Treatment Outcome

Methods: Patients requiring a single-level TLIF were divided into two groups. In the TXA group (n=75), the wound surface was soaked with TXA (1 g in 100 mL saline solution) for 3 minutes after exposure, after decompression, and before wound closure, and in the control group (n=175) using only saline. Intraoperative blood loss drain volume was recorded on each of the first 2 days immediately after surgery. An estimated cost analysis was made on the basis of the length of hospital stay and the blood transfusion. Results: IBL for the control group was 783.33±332.71 mL and for intervention group 410.57±189.72 mL (p <0.001). The operative time for control group was 3.24±0.38 hours and for intervention group 2.99±0.79 hours (p <0.695). Hemovac drainage on days 1 and 2 for control group was 167.10±53.83 mL and 99.33±37.5 mL, respectively, and for intervention group 107.03±44.37 mL and 53.38±21.99 mL, respectively (p <0.001). The length of stay was significantly shorter in the intervention group (4.8±1.1 days) compared to control group (7.0±2.3 days). The cost of treatment in the intervention group was US dollar (USD) 4,552.57±1,222.6 compared with that in the control group USD 6,529.9±1,505.04. Conclusions Topical TXA is a viable, cost-effective method of decreasing perioperative blood loss in major spine surgery with fewer overall complications than other methods. Further studies are required to find the ideal dosage and timing.