Recurrence rates of PSD were found to be similar in both study groups. Post-operative seroma rate was significantly higher in the KF group. The meta-analysis did not indicate any further statistically significant differences between the two surgical procedures.

Laparoscopic Nissen fundoplication is a safe method with significant long-term efficacy in terms of symptom control and quality of life, even when; performed in a low-volume, community-hospital setting.

The laparoscopic approach for repair of large hiatal hernias is a relatively safe method with significant long-term efficacy in terms of symptom control and quality of life.