|LETTER TO EDITOR
|Year : 2020 | Volume
| Issue : 4 | Page : 858-859
Authors' reply to Gupta et al.
S Anand1, Vikrant Singh1, Pankaj Kumar Sahu2
1 Department of Surgery, Armed Forces Medical College, Pune, Maharashtra, India
2 Department of ENT, Command Hospital (Air Force), Bengaluru, Karnataka, India
|Date of Submission||29-Oct-2020|
|Date of Decision||10-Nov-2020|
|Date of Acceptance||15-Nov-2020|
|Date of Web Publication||25-Dec-2020|
Department of Surgery, Armed Forces Medical College, Pune - 411 040, Maharashtra
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Anand S, Singh V, Sahu PK. Authors' reply to Gupta et al. Cancer Res Stat Treat 2020;3:858-9
We are pleased with the response and appreciate the expert comments from Deshpande et al. on our article about the role of topical tranexamic acid (TXA) in cancers of the head-and-neck region. The feedback adds to our unerstanding and insight on the subject matter and will enable us to carry out more precise research in the near future. As brought out by us in the discussion and reiterated by the authors, ours was a pilot study with a simple methodology. It had limitations, some of which have been highlighted by us in the discussion. As rightly pointed out by Shah and Thiagarajan, the statistical power of the study could have been set at 95%. However, the Armed Forces Institute where this study was conducted is a general surgical oncology center and does not have a dedicated head-and-neck unit. As a result, the case load of head-and-neck cancers was not high enough to enable us to have a larger sample size. With this limitation in mind, we planned this study with a simple methodology. As a result, we also did not have the liberty of stratifying the operated cases based on the type of neck dissection.
It has also been pointed out that we used <20 mL/day of drain output for 2 consecutive days as the cutoff for drain removal, whereas most centers use <50 mL of drain output over 24 h as the cutoff. We concede that our hospital, being a tertiary care referral center of the Armed Forces Medical Services, has a large catchment area, with majority of the patients coming from a rural background with limited access to dedicated health-care facilities. A lower cutoff was set deliberately so that the majority of the drain-related complications could be dealt with within the index admission and the patient could be discharged with a greater assurance for both the patient and the operating surgeon. However, we acknowledge the need for more trials on the role of topical TXA in head-and-neck surgery before it can be recommended for routine clinical use.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Deshpande M, Gupta I, Chaudhari S. Exploring the efficacy of topical tranexamic acid in head and neck cancer surgery. Cancer Res Stat Treat 2020;3:857-8. [Full text]
Anand S, Singh V, Sahu PK. Evaluating the role of topical tranexamic acid in cancers of the head and neck: A single-center randomized controlled trial. Cancer Res Stat Treat 2020;3:461-6. [Full text]
Shah S, Thiagarajan S. Utility of topical tranexamic acid in head and neck cancer surgery: A myth or reality? Cancer Res Stat Treat 2020;3:572-3. [Full text]
Darling H S. Basics of statistics-3: Sample size calculation – (i). Cancer Res Stat Treat 2020;3:317-22. [Full text]
Harris T, Doolarkhan Z, Fagan JJ. Timing of removal of neck drains following head and neck surgery. Ear Nose Throat J 2011;90:186-9.