Reviewer ’s report  
 
Title: Endoscopic Injection Sclerotherapy versus N -butyl -2 cyanoacrylate injection in the 
Management of Actively Bleeding Esophageal Varices: A Randomized Control Trial  
 
Version: 4 Date: 21 Jan 2018  
 
Reviewer: Satoru Kakizaki  
 
Reviewer's report:  
 
BMGE -D-17-00475R4  
Authors evaluated the e ffect of endoscopic injection sclerotherapy and N -butyl -2 cyanoacrylate 
injection in the management of actively bleeding esophageal varices by a randomized control 
trial. Initial hemostasis was significantly higher in cyanoacrylate versus sclerotherapy gro ups. No 
significant differences between two groups regarding rebleeding, complications, hospital stay or 
mortality rate were observed. They concluded that both of therapies appear to have relatively 
favorable outcomes, although cyanoacrylate injection may be superior to sclerotherapy for initial 
control of active bleeding. This study has potentially interesting things. However, there are 
several criticisms to be clarified.  
 
<Major point>  
1. This study was conducted during the period from January 2016 to Aug ust 2017. However, 
the date of trial registration was 1 January 2018. I do not know whether editorial office allow 
this delay of registration. Please check it.  
 
2. The Kaplan -Meier curve of rebleednig is helpful for readers.  
<Minor point>  
1. Page 11, lin e 44. (P 0.007) may be (P=0.007).  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify whic h controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financi ally from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organiz ation that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of th e above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
No COI.  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the autho rs and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
 
Title: Endoscopic Injection Sclerotherapy versus N -butyl -2 cyanoacrylate injection in the 
Management of Actively Bleeding Esophageal Varices: A Randomized Control Trial  
 
Version: 4 Date: 21 Jan 2018  
 
Reviewer: Satoru Kakizaki  
 
Reviewer's report:  
 
BMGE -D-17-00475R4  
Authors evaluated the e ffect of endoscopic injection sclerotherapy and N -butyl -2 cyanoacrylate 
injection in the management of actively bleeding esophageal varices by a randomized control 
trial. Initial hemostasis was significantly higher in cyanoacrylate versus sclerotherapy gro ups. No 
significant differences between two groups regarding rebleeding, complications, hospital stay or 
mortality rate were observed. They concluded that both of therapies appear to have relatively 
favorable outcomes, although cyanoacrylate injection may be superior to sclerotherapy for initial 
control of active bleeding. This study has potentially interesting things. However, there are 
several criticisms to be clarified.  
 
<Major point>  
1. This study was conducted during the period from January 2016 to Aug ust 2017. However, 
the date of trial registration was 1 January 2018. I do not know whether editorial office allow 
this delay of registration. Please check it.  
 
2. The Kaplan -Meier curve of rebleednig is helpful for readers.  
<Minor point>  
1. Page 11, lin e 44. (P 0.007) may be (P=0.007).  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify whic h controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financi ally from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organiz ation that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of th e above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
No COI.  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the autho rs and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Please review this paper.
user
Reviewer ’s report  
 
Title: Endoscopic Injection Sclerotherapy versus N -butyl -2 cyanoacrylate injection in the 
Management of Actively Bleeding Esophageal Varices: A Randomized Control Trial  
 
Version: 4 Date: 21 Jan 2018  
 
Reviewer: Satoru Kakizaki  
 
Reviewer's report:  
 
BMGE -D-17-00475R4  
Authors evaluated the e ffect of endoscopic injection sclerotherapy and N -butyl -2 cyanoacrylate 
injection in the management of actively bleeding esophageal varices by a randomized control 
trial. Initial hemostasis was significantly higher in cyanoacrylate versus sclerotherapy gro ups. No 
significant differences between two groups regarding rebleeding, complications, hospital stay or 
mortality rate were observed. They concluded that both of therapies appear to have relatively 
favorable outcomes, although cyanoacrylate injection may be superior to sclerotherapy for initial 
control of active bleeding. This study has potentially interesting things. However, there are 
several criticisms to be clarified.  
 
<Major point>  
1. This study was conducted during the period from January 2016 to Aug ust 2017. However, 
the date of trial registration was 1 January 2018. I do not know whether editorial office allow 
this delay of registration. Please check it.  
 
2. The Kaplan -Meier curve of rebleednig is helpful for readers.  
<Minor point>  
1. Page 11, lin e 44. (P 0.007) may be (P=0.007).  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify whic h controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financi ally from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organiz ation that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of th e above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
No COI.  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the autho rs and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant