Which surgical procedure offers the best treatment for XXXX ?

@entity1 @entity66 @entity28 @entity2737 @entity281
PURPOSE: Our aim was to determine the most effective surgical procedure for treatment of @entity66 , by comparing different surgical techniques. METHODS: A total of 354 @entity1 who underwent operation for @entity66 were enrolled in this prospective study. The data included @entity1 's demographic characteristics, age, gender, body mass index, occupation, smoking, concomitant diseases, surgeon's experience, wound-healing problems (wound separation and @entity281 ), time to return to work, and development of recurrence. RESULTS: Of the 354 @entity1 , total excision   +   primary closure was performed in 133 (37.6%), D-flap in 101 (28.5%), Karydakis technique in 74 (20.9%), and Limberg flap surgery in 46 (13%). The male/female ratio was 8.5:1, which is a statistically significant difference (p   <   0.05). The average follow-up period was 37  months (range, 12-97  months); during this period, wound-healing problems were observed in 70 (19.7%) @entity1 , and 34 (9.6%) @entity1 developed recurrence. There was no difference in the rate of recurrence of @entity66 between procedures done by trainees and staff surgeons. Recurrence rates were similar for all four treatment methods (7.5-13.5%). Wound-healing problems were higher for D-flap than for other methods (p   =   0.027). The average time to return to work with the D-flap method was longer than that for the other methods (p   <   0.01). Recurrence increased 14.44-fold following the development of @entity2737 . Higher recurrence rates were also noted in @entity28 @entity1 (8.10-fold) and in females (6.72-fold). CONCLUSIONS: Despite the increasing volume of data on the treatment of @entity66 , the optimal treatment has yet to be established.
