Sliding and Paraesophageal Hiatal Hernias are Distinct Diseases: Surgeons are Responsible for Delineating the Differences

Abstract

The outcomes for sliding and paraesophageal hiatal hernias (PHH) are jointly reported. By combining outcomes of sliding hernia and PHH repair, surgeons are conflating the outcomes of surgical management for GERD with the outcomes of PHH repair. PHH is a distinct clinical entity from sliding hernia, requiring a more complex operation with higher risk of complications and, ultimately, comparatively diminished outcomes. The practice of combining PHH and sliding hernia surgical data confounds the true outcomes of ARS and contributes to misconceptions that reduce referral rates. Current and future research assessments must be based on accurate discrimination between the 2 anatomic presentations. Surgeons have a responsibility to ensure this distinction is clearly drawn when disseminating their ARS outcomes.