Cyanoacrylate Injection Compared with Band Ligation for Acute Gastric Variceal Hemorrhage: A Meta-Analysis of Randomized Controlled Trials and Observational Studies
Table 4
Results of subgroup analyses.
Variable
Number of patients
Combined results (95% CI)
Model
(%)
P value for heterogeneity
Hemostasis of active bleeding
Study design
RCT
4 (232)
2.64 (1.15, 6.05)
Fixed effect
0.0
0.407
Retrospective
2 (167)
1.81 (0.59, 5.60)
Fixed effect
0.0
0.456
GV type
Overall
1 (30)
1.00 (0.06, 17.62)
—
—
—
GOV1+2
1 (26)
7.80 (1.16, 52.35)
—
—
—
GOV1
4 (337)
2.34 (1.17, 4.69)
Fixed effect
0.0
0.599
Proportion of HCC
Higher (>median)
3 (241)
3.87 (1.11, 13.52)
Fixed effect
0.0
0.500
Lower (<median)
2 (312)
1.89 (0.86, 4.51)
Fixed effect
0.0
0.562
GV rebleeding
Study design
RCT
3 (215)
0.43 (0.20, 0.92)
Random effects
56.0
0.103
Prospective
1 (37)
0.28 (0.12, 0.68)
—
—
—
GV type
Overall
2 (157)
0.32 (0.19, 0.55)
Fixed effect
7.1
0.300
GOV1+2
2 (95)
0.52 (0.14, 1.99)
Random effects
70.0
0.068
Proportion of HCC
Higher (>median)
2 (157)
0.32 (0.19, 0.55)
Fixed effect
7.1
0.300
Lower (<median)
1 (37)
0.28 (0.12, 0.68)
—
—
—
Variceal obliteration
GV type
Overall
2 (157)
1.02 (0.54, 1.95)
Fixed effect
0.0
0.530
GOV1+2
1 (58)
0.91 (0.29, 2.88)
—
—
—
GOV1
1 (150)
0.19 (0.02, 1.66)
—
—
—
Proportion of HCC
Higher (>median)
2 (157)
1.02 (0.54, 1.95)
Fixed effect
0.0
0.530
Lower (<median)
1 (150)
0.19 (0.02, 1.66)
—
—
—
Treatment sessions
Study design
RCT
3 (307)
−0.46 (−1.58, 0.66)
Random effects
95.3
0.000
Prospective
1 (37)
−0.86 (−1.53, −0.18)
—
—
—
GV type
Overall
2 (157)
0.07 (−0.63, 0.77)
Random effects
78.5
0.031
GOV1+2
1 (37)
−0.86 (−1.53, −0.18)
—
—
—
GOV1
1 (150)
−1.51 (−1.87, −1.15)
—
—
—
Proportion of HCC
Higher (>median)
2 (157)
0.05 (−0.64, 0.73)
Random effects
78.4
0.032
Lower (<median)
2 (187)
−0.99 (−1.20, −0.79)
Fixed effect
0.0
0.852
Complications (overall)1
Study design
RCT
3 (215)
0.58 (0.32, 1.06)
Fixed effect
0.0
0.386
Prospective
1 (37)
0.93 (0.22, 3.96)
—
—
—
Retrospective
2 (246)
0.95 (0.51, 1.79)
Fixed effect
0.0
0.804
GV type
Overall
2 (157)
0.68 (0.32, 1.41)
Fixed effect
28.6
0.263
GOV1+2
2 (95)
0.56 (0.24, 1.31)
Fixed effect
0.0
0.393
GOV1
2 (246)
0.95 (0.51, 1.79)
Fixed effect
0.0
0.804
Proportion of HCC
Higher (>median)
3 (241)
0.70 (0.37, 1.35)
Fixed effect
0.0
0.485
Lower (<median)
2 (199)
0.98 (0.52, 1.84)
Fixed effect
0.0
0.938
Complications (ulcers/ulcer bleeding)
Study design
RCT
2 (210)
0.92 (0.03, 33.71)
Random effects
77.9
0.033
Prospective
1 (37)
0.17 (0.01, 3.78)
—
—
—
Retrospective
2 (246)
0.30 (0.14, 0.65)
Fixed effect
0.0
0.994
GV type
Overall
1 (60)
0.18 (0.03, 0.94)
—
—
—
GOV1+2
1 (37)
0.17 (0.01, 3.78)
—
—
—
GOV1
3 (396)
0.37 (0.18, 0.76)
Fixed effect
51.2
0.129
Proportion of HCC
Higher (>median)
2 (144)
0.21 (0.05, 0.86)
Fixed effect
0.0
0.759
Lower (<median)
3 (349)
0.36 (0.17, 0.74)
Fixed effect
53.6
0.116
Complications (infections)
Study design
RCT
4 (365)
1.11 (0.56, 2.18)
Fixed effect
15.4
0.315
Prospective
1 (37)
1.33 (0.25, 7.01)
—
—
—
Retrospective
2 (246)
0.72 (0.35, 1.49)
Fixed effect
0.0
0.742
GV type
Overall
2 (157)
0.88 (0.38, 2.03)
Fixed effect
0.0
0.941
GOV1+2
2 (95)
1.07 (0.37, 3.06)
Fixed effect
0.0
0.735
GOV1
3 (396)
0.92 (0.46, 1.83)
Fixed effect
54.1
0.113
Proportion of HCC
Higher (>median)
3 (241)
0.89 (0.42, 1.88)
Fixed effect
0.0
0.995
Lower (<median)
3 (349)
0.98 (0.50, 1.94)
Fixed effect
55.7
0.104
GVO: cyanoacrylate injection; GVL: band ligation; GV: gastric varices; GOV: gastroesophageal varices; HCC: hepatocellular carcinoma; RCT: randomized controlled trial; CI: confidence interval; OR: odds ratio.
1Study by El Amin et al. [12] was excluded owing to heterogeneity.
