Work

Clinical significance of hiatus hernia on Barrett’s oesophagus: a scoping review

Year: 2026

Type: article

Abstract: BACKGROUND: Hiatal hernia (HH) is commonly observed in patients with Barrett’s oesophagus (BO), a premalignant condition that may progress to oesophageal adenocarcinoma (OAC). While HH has been implicated in BO pathogenesis, it is not formally recognised as a major risk factor in leading international clinical guidelines. This systematic scoping review aimed to evaluate the role of HH in the development, progression, and treatment outcomes of BO. METHODS: A systematic scoping review was conducted, searching through databases (PubMed, Medline, Embase, Scopus). RESULTS: A total of sixty-six articles were included with majority comprised of observational studies. HH was strongly associated with BO development, particularly in cases with larger hernia size (> 2–4 cm) and long-segment BO. While inconsistent, there could BO a trend towards dysplastic and malignant progression of BO in HH. HH may impair the efficacy of radiofrequency ablation, with larger hernias requiring more treatment sessions. CONCLUSION: Current evidence supports HH as a significant risk factor for BO onset. Its role in progression and management warrants further investigation. Surgical repair may be beneficial in selected asymptomatic patients, especially those with hernias ≥ 4 cm and established BO, to restore the gastro-oesophageal anatomy and eliminate reflux-prone micro-environment.

Source: Langenbeck s Archives of Surgery

DOI: 10.1007/s00423-026-03981-z

Authors: Lee S. Kyang, Nurojan Vivekanandamoorthy, Manjunath Siddaiah-Subramanya

Institutions: Bankstown Lidcombe Hospital, UNSW Sydney, Western Sydney University

Language: English

Topic: Esophageal Cancer Research and Treatment

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $4,590