Background <p>Gastroesophageal reflux disease (GERD) is a global health burden, and the optimal choice among various laparoscopic antireflux procedures remains debated. We compared the effectiveness of five surgical techniques—Nissen, Toupet, Dor, His angle reconstruction, and W–H fundoplication—over a 1-year postoperative period.</p> Materials <p>In this single-center retrospective cohort (January 2016-May 2024), 359 GERD patients underwent one of the five laparoscopic procedures. Total symptom score, SF-36 PCS/MCS, GERD-HRQL, and EAT-10 were assessed longitudinally. Longitudinal trajectories were analyzed using linear mixed-effects models with estimated marginal means. Multivariable (Firth) logistic regression was used to identify the predictors of 1-year symptom recurrence and persistent PPI dependence.</p> Results <p>All five procedures were associated with sustained symptom improvement and significant gains in physical and mental quality of life over 1&#xa0;year. Early postoperative dysphagia differed among procedures—most pronounced after Nissen—but converged by 6 to 12&#xa0;months, with near-normal EAT-10 scores across groups at 1&#xa0;year. No clinically meaningful between-procedure differences were observed in patient-reported outcomes at 1&#xa0;year. Preoperative symptom severity was the only independent predictor of symptom recurrence (OR = 1.13 per point increase; <i>P</i> &lt; 0.001), whereas surgical type was not associated with symptom recurrence or PPI dependence after adjustment.</p> Conclusions <p>These five laparoscopic antireflux procedures were associated with substantial improvement in patient-reported symptoms and quality of life at 1&#xa0;year. Early postoperative dysphagia differed among procedures but largely resolved over time. Mid-term outcomes appear to depend more on baseline symptom burden and phenotype-informed procedure selection than on adherence to a single universal “gold standard” technique.</p> Graphical abstract <p></p>