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Cyanoacrylate injection compared with band ligation for acute gastric variceal hemorrhage: a meta-analysis of randomized controlled trials and observational studies.

Ye X, Huai J, Chen Y - Gastroenterol Res Pract (2014)

Bottom Line: For each outcome, data were pooled using a fixed-effect or random-effects model according to the result of a heterogeneity test.Results.Additional studies are warranted to enable definitive conclusions.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology and Hepatology, Jinhua Municipal Central Hospital, Jinhua Hospital of Zhejiang University, Jinhua, Zhejiang 321000, China.

ABSTRACT
Background. Cyanoacrylate injection (GVO) and band ligation (GVL) are effective treatments for gastric variceal hemorrhage. However, data on the optimal treatment are still controversial. Methods. For our overall analysis, relevant studies were identified from several databases. For each outcome, data were pooled using a fixed-effect or random-effects model according to the result of a heterogeneity test. Results. Seven studies were included. Compared with GVL, GVO was associated with increased likelihood of hemostasis of active bleeding (odds ratio [OR] = 2.32; 95% confidence interval [CI] = 1.19-4.51) and a longer gastric variceal rebleeding-free period (hazard ratio = 0.37; 95% CI = 0.24-0.56). No significant differences were observed between GVL and GVO for mortality (hazard ratio = 0.66; 95% CI = 0.43-1.02), likelihood of variceal obliteration (OR = 0.89; 95% CI = 0.52-1.54), number of treatment sessions required for complete variceal eradication (weighted mean difference = -0.45; 95% CI = -1.14-0.23), or complications (OR = 1.02; 95% CI = 0.48-2.19). Conclusion. GVO may be superior to GVL for achieving hemostasis and preventing recurrence of gastric variceal rebleeding but has no advantage over GVL for mortality and complications. Additional studies are warranted to enable definitive conclusions.

No MeSH data available.


Related in: MedlinePlus

Comparison of rebleeding of gastric varices in the GVO and GVL groups. GVO, cyanoacrylate injection; GVL, band ligation; CI, confidence interval; HR, hazard ratio.
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fig4: Comparison of rebleeding of gastric varices in the GVO and GVL groups. GVO, cyanoacrylate injection; GVL, band ligation; CI, confidence interval; HR, hazard ratio.

Mentions: Data on GV rebleeding were extracted from four studies [8, 9, 13, 17]. In the pooled data analysis, a fixed effect model indicated that GVO was associated with a statistically significant 63% reduction in the hazard of GV rebleeding (HR = 0.37; 95% CI = 0.24–0.56; Figure 4). There was no significant heterogeneity across studies (I2 = 40.2%; P = 0.17).


Cyanoacrylate injection compared with band ligation for acute gastric variceal hemorrhage: a meta-analysis of randomized controlled trials and observational studies.

Ye X, Huai J, Chen Y - Gastroenterol Res Pract (2014)

Comparison of rebleeding of gastric varices in the GVO and GVL groups. GVO, cyanoacrylate injection; GVL, band ligation; CI, confidence interval; HR, hazard ratio.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4020398&req=5

fig4: Comparison of rebleeding of gastric varices in the GVO and GVL groups. GVO, cyanoacrylate injection; GVL, band ligation; CI, confidence interval; HR, hazard ratio.
Mentions: Data on GV rebleeding were extracted from four studies [8, 9, 13, 17]. In the pooled data analysis, a fixed effect model indicated that GVO was associated with a statistically significant 63% reduction in the hazard of GV rebleeding (HR = 0.37; 95% CI = 0.24–0.56; Figure 4). There was no significant heterogeneity across studies (I2 = 40.2%; P = 0.17).

Bottom Line: For each outcome, data were pooled using a fixed-effect or random-effects model according to the result of a heterogeneity test.Results.Additional studies are warranted to enable definitive conclusions.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology and Hepatology, Jinhua Municipal Central Hospital, Jinhua Hospital of Zhejiang University, Jinhua, Zhejiang 321000, China.

ABSTRACT
Background. Cyanoacrylate injection (GVO) and band ligation (GVL) are effective treatments for gastric variceal hemorrhage. However, data on the optimal treatment are still controversial. Methods. For our overall analysis, relevant studies were identified from several databases. For each outcome, data were pooled using a fixed-effect or random-effects model according to the result of a heterogeneity test. Results. Seven studies were included. Compared with GVL, GVO was associated with increased likelihood of hemostasis of active bleeding (odds ratio [OR] = 2.32; 95% confidence interval [CI] = 1.19-4.51) and a longer gastric variceal rebleeding-free period (hazard ratio = 0.37; 95% CI = 0.24-0.56). No significant differences were observed between GVL and GVO for mortality (hazard ratio = 0.66; 95% CI = 0.43-1.02), likelihood of variceal obliteration (OR = 0.89; 95% CI = 0.52-1.54), number of treatment sessions required for complete variceal eradication (weighted mean difference = -0.45; 95% CI = -1.14-0.23), or complications (OR = 1.02; 95% CI = 0.48-2.19). Conclusion. GVO may be superior to GVL for achieving hemostasis and preventing recurrence of gastric variceal rebleeding but has no advantage over GVL for mortality and complications. Additional studies are warranted to enable definitive conclusions.

No MeSH data available.


Related in: MedlinePlus