The optimal method of repair of hiatal hernia of 5–8 cm is combined mesh alloplasty and cruroraphy. The best method of repair of hiatal hernia more than 8 cm is tension-free mesh alloplasty. Adding an antireflux procedure is necessary in patients with esophageal achalasia associated with hiatal hernia. No antireflux procedure is advisable in remaining patients for prevention of recurrence and reduction of surgery time.
