Procedures
Staple line hemorrhage
The intervention group received a single dose of 1500-mg TXA (Cyklokapron©) during the induction of the procedure. TXA was administered intravenously, dissolved in 100-ml sodium chloride (NaCl) 0.9% in a time frame of 15–30 min, with a maximum of 100 mg/min. The control group received a placebo during the induction of the procedure. The placebo infusion contained 100-ml NaCl 0.9%, which was administered similarly. The hospital’s pharmacy prepared and labeled the investigational medicinal products according to the relevant Good Manufacturing Practice (GMP) guidelines [To determine postoperative hemoglobin levels, a blood sample (one EDTA tube) was obtained within 1 week preoperatively and at day one postoperatively by venipuncture and analyzed in the hospital’s clinical chemistry laboratory according to standard procedures. In all patients, the same staple devices (ECHELON FLEX™ GST) to dissect the stomach and energy device (Harmonic®) were used, starting always with a golden cartridge (3.0 mm), followed by blue (2.4 mm) and rarely green (3.4 mm). All patients were treated by expert bariatric surgeons. Staple line hemorrhage was checked according to a step-by-step protocol (see supplementary files 1 and 2 [