Meta-Analysis
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Nov 15, 2023; 15(11): 1988-1997
Published online Nov 15, 2023. doi: 10.4251/wjgo.v15.i11.1988
Efficacy and safety of gastroscopic hemostasis in the treatment of acute gastric hemorrhage: A meta-analysis
Hai-Yan Pan, Xiao-Wei Wang, Qiong-Xiao He, Yi-Dan Lu, Wan-Yi Zhang, Jian-Wei Jin, Bin Lin
Hai-Yan Pan, Qiong-Xiao He, Wan-Yi Zhang, Bin Lin, Department of Emergency Medicine, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310005, Zhejiang Province, China
Xiao-Wei Wang, Department of Cardiopulmonary Rehabilitation, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310005, Zhejiang Province, China
Yi-Dan Lu, Department of Ultrasound, Zhejiang Cancer Hospital, Hangzhou 310005, Zhejiang Province, China
Jian-Wei Jin, Department of Oncology, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310005, Zhejiang Province, China
Author contributions: Lin B and Pan HY contributed to conception and design; Lin B contributed to administrative support; Lin B and Pan HY contributed to provision of study materials or patients; Pan HY, Wang XW, He QX, Lu YD; Zhang WY, Jin JW and Lin B contributed to collection and assembly of data; Lin B and Pan HY contributed to data analysis and interpretation; All authors contributed to manuscript writing, final approval of manuscript.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bin Lin, MS, Staff Physician, Department of Emergency Medicine, The Third Affiliated Hospital of Zhejiang Chinese Medical University, No. 219 Moganshan Road, Hangzhou 310005, Zhejiang Province, China. 18268051213@163.com
Received: August 24, 2023
Peer-review started: August 24, 2023
First decision: September 11, 2023
Revised: September 19, 2023
Accepted: September 27, 2023
Article in press: September 27, 2023
Published online: November 15, 2023
Processing time: 83 Days and 12 Hours
Abstract
BACKGROUND

Gastric cancer (GC) is a malignant tumor with a high incidence and mortality rate worldwide for which acute bleeding is a common clinical complication. Gastroscopic hemostasis is an important method for treating acute bleeding in GC; however, its efficacy and safety remain controversial.

AIM

To systematically analyze the efficacy and safety of gastroscopic hemostasis for the treatment of acute gastric hemorrhage.

METHODS

The PUBMED, Web of Science, Wiley Library, EMBASE, Wanfang, CNKI, and VIP databases were searched for studies related to gastroscopic hemostatic treatment for acute GC published through February 20, 2023. The literature was screened according to the inclusion and exclusion criteria, data were extracted, and literature quality was evaluated. The meta-analysis was performed using RevMan software (version 5.3), while Begg’s test for publication bias was performed using Stata 13.0 software.

RESULTS

Six randomized controlled trials and two retrospective analyses were retrieved. Five studies had a low, two had an uncertain, and one had a high risk of bias. Compared with the control group, the hemostatic rate of gastroscopic hemostasis was increased [relative risk (RR) = 1.24; 95% confidence interval (CI): 1.08 to 1.43; P = 0.003]; the rate of rebleeding (RR = 0.27; 95%CI: 0.09 to 0.80; P = 0.02), rate of surgery transfer (RR = 0.16; 95%CI: 0.06 to 0.43; P = 0.0003), serum C-reactive protein level [mean difference (MD) = -5.16; 95%CI: -6.11 to 4.21; P < 0.00001], interleukin-6 level (MD = -6.37; 95%CI: -10.33 to -2.42; P = 0.002), and tumor necrosis factor-α level (MD = -2.29; 95%CI: -4.06 to -0.52; P = 0.01) were decreased; and the quality of life improvement rate was increased (RR = 1.95; 95%C I= 1.41-2.71; P < 0.0001). Begg’s test revealed no significant publication bias.

CONCLUSION

The efficacy and safety of endoscopic hemostasis were higher than those of the control group, suggesting that it is an effective treatment for acute GC hemorrhage.

Keywords: Gastroscope; Gastric cancer; Acute bleeding; Curative effect; Security; Meta-analysis

Core Tip: This meta-analysis provides a wealth of evidence emphasizing the effectiveness and safety of endoscopic hemostasis for treating acute gastrointestinal bleeding in patients with gastric cancer (GC). Compared with the control group, endoscopic hemostasis effectively controlled acute gastric bleeding in GC while significantly reducing the bleeding and transfer rates, indicating its efficacy at treating patients with acute gastric bleeding in GC. Nevertheless, further high-quality clinical research is required to confirm the safety and efficacy of endoscopic hemostasis in the treatment of acute GC bleeding.