{Reference Type}: Journal Article
{Title}: Association between hiatal hernia and Barrett's esophagus: an updated meta-analysis with trial sequential analysis.
{Author}: Ma S;Tong Z;He Y;Zhang Y;Guo X;Qi X;
{Journal}: Therap Adv Gastroenterol
{Volume}: 17
{Issue}: 0
{Year}: 2024
{Factor}: 4.802
{DOI}: 10.1177/17562848231219234
{Abstract}: <B>UNASSIGNED: </B>Barrett's esophagus (BE) is a precursor of esophageal adenocarcinoma. It is critical to recognize the risk factors associated with BE.<BR><B>UNASSIGNED: </B>The present meta-analysis aims to systematically estimate the association of hiatal hernia with the risk of BE.<BR><B>UNASSIGNED: </B>A meta-analysis with trial sequential analysis.<BR><B>UNASSIGNED: </B>The PubMed, EMBASE, and Cochrane Library databases were searched. The pooled odds ratios (ORs) and adjusted ORs (aORs) with their 95% confidence intervals (CIs) were calculated for the combined estimation of unadjusted data and data adjusted for confounders, respectively. Heterogeneity was quantified using the Cochrane Q test and I² statistics. Subgroup, meta-regression, and leave-one-out sensitivity analyses were employed to explore the sources of heterogeneity.<BR><B>UNASSIGNED: </B>Forty-seven studies with 131,517 participants were included. Based on the unadjusted data from 47 studies, hiatal hernia was significantly associated with an increased risk of any length BE (OR = 3.91, 95% CI = 3.31-4.62, p < 0.001). The heterogeneity was significant (I² = 77%; p < 0.001) and the definition of controls (p = 0.014) might be a potential contributor to heterogeneity. Based on the adjusted data from 14 studies, this positive association remained (aOR = 3.26, 95% CI = 2.44-4.35, p < 0.001). The heterogeneity was also significant (I² = 65%; p < 0.001). Meta-analysis of seven studies demonstrated that hiatal hernia was significantly associated with an increased risk of long-segment BE (LSBE) (OR = 10.01, 95% CI = 4.16-24.06, p < 0.001). The heterogeneity was significant (I² = 78%; p < 0.001). Meta-analysis of seven studies also demonstrated that hiatal hernia was significantly associated with an increased risk of short-segment BE (OR = 2.76, 95% CI = 2.05-3.71, p < 0.001). The heterogeneity was not significant (I² = 30%; p = 0.201).<BR><B>UNASSIGNED: </B>Hiatal hernia should be a significant risk factor for BE, especially LSBE.<BR><B>UNASSIGNED: </B>PROSPERO registration number CRD42022367376.