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Complex hiatus hernias. Diagnostic and therapeutic management recommendations
Marcos Bruna1, María Asunción Acosta2, Silvia Carbonell3
1Hospital Vithas 9 de Octubre (Valencia), Hospital Quirónsalud Huelva, Spain.
Cirugia Espanola
|January 11, 2026
Summary
Hiatus hernia (HH) management lacks clear guidelines. This study provides expert recommendations for complex HH cases, highlighting areas needing further research.
Area of Science:
- Gastroenterology and Surgical Science
- Clinical Practice Guidelines
Background:
- Hiatus hernia (HH) is common, but lacks precise diagnostic and therapeutic guidelines.
- Complex HH cases, including Type III/IV hernias, large hernias, or recurrences, require specific management strategies.
Purpose of the Study:
- To establish clinical recommendations for diagnosing and treating complex hiatus hernias.
- To address 13 controversial aspects of hiatus hernia management based on current evidence and expert consensus.
Main Methods:
- Systematic review of current scientific evidence.
- Consensus development by a panel of 28 expert surgeons.
- Application of the GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology.
Main Results:
- Developed recommendations for complex hiatus hernia management.
- Identified areas with high-quality evidence and strong recommendations.
- Highlighted specific controversial points requiring further investigation.
Conclusions:
- The guidelines offer expert consensus for complex hiatus hernia management.
- Further high-quality prospective studies are necessary to resolve remaining controversies and refine treatment protocols.
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