Research Development

Staff Publications

 Small purple icon of a book with a magnifying glass on top  Staff Publications

Find out what your colleagues have been writing. This section features articles published by staff working for St Helens and Knowsley Teaching Hospitals and Halton, Knowsley and St Helens community staff.

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All publications by 'Rajaganeshan R'



Mersey and West Lancashire Teaching Hospitals NHS Trust – St Helens & Knowsley Staff

205 Single-Centre Review on Incisional Hernia After Laparoscopic Anterior Resection: What Is the Ideal Incision for Specimen Extraction?

Abstract Midline incision was reported as the common site of incisional hernia (IH) after hand-assisted laparoscopic anterior resection (LAR). There is no consensus on the ideal site for specimen extraction. Our aim was to compare the rate of IH at various specimen extraction sites at our institution. Method We retrospectively..

Published: 30/08/2023
Authors: Win M, Ngo V, Jeyam T, Rajaganeshan R

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O132 Preliminary results of radiofrequency ablation for haemorrhoidal disease at a district general hospital

Introduction Haemorrhoidal disease (HD) is a common perianal condition. There is still limited data on the role of minimally invasive surgery for HD. The aim of our study was to report the outcome of radiofrequency ablation of haemorrhoids under local anaesthetic (RAFAELO) at our institution. Methods 23 patients who had a..

Published: 10/05/2023
Authors: Win M, Ngo V, Rajaganeshan R

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P014 Video assisted anal fistula treatment (VAAFT): A 5 year review

Aim VAAFT is claimed to be the only technique that allows the surgeon to see inside the anal fistula tract and locate the internal opening using an endoscope light. It is designed to only affect the fistula tract and there preserve sphincter function and faecal continence. Our aim was to..

Published: 06/09/2022
Authors: Alfred J, Santoro G, Beggs R, Brookes J, Rajaganeshan R

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P066 Incisional hernia rate following laparoscopic anterior resection. Does extraction site matter?

Aim Incisional hernia are an established complication following abdominal surgery. There is limited data available on the relationship between formation of an incisional hernia and choice of extraction site for patients undergoing a laparoscopic anterior resection. This study aimed to determine the prevalence of incisional hernia following this operation and..

Published: 06/09/2022
Authors: Botzenhardt E, Clifford R, Rajaganeshan R

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Colorectal resections during the COVID-19 pandemic: a national survey of practice during first lockdown

Introduction The first wave of the COVID-19 pandemic led to an unprecedented time for the management of colorectal cancer, with uncertainty as to cancer-specific risks and the circumventing of gold standard oncological strategies. Our study aimed to acquire a snapshot of the practice of multidisciplinary team (MDT) management and variability..

Published: 23/12/2021
Authors: Rajput K, Clifford R, Rajaganeshan R, Kalaiselvan R

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Impact of Mucopexy during Trans-Anal Haemorrhoidal Dearterialization on Post-operative pain and Recurrence in Hemorrhoidal Disease

Background Single center experience of trans-anal haemorrhoidal dearterialization (THD) with and without mucopexy; evaluating differences in recurrence, pain and post-operative complications Method Retrospective analysis of all patients undergoing THD between October 2014-September 2016, with and without mucopexy procedure depending on clinical need. Primary outcome was symptom recurrence; this was evaluated during..

Published: 15/09/2021
Authors: Kearsey C, Javed M, Rajaganeshan R

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The right to take risk: are we practising informed consent during the COVID pandemic?

Dear Editor Since the beginning of the global pandemic there has been a paternalistic approach to consenting patients for surgery. This is both because of guidance from overseeing organizations, and individual concern about significant morbidity and mortality. The first wave of the pandemic saw a shift towards less surgery in..

Published: 13/03/2021
Authors: Davidson T, Singh V, Kalaiselvan R, Rajaganeshan R

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Suture rectopexy versus ventral mesh rectopexy for complete full-thickness rectal prolapse and intussusception: systematic review and meta-analysis

Background This systematic review and meta-analysis aimed to compare recurrence rates of rectal prolapse following ventral mesh rectopexy (VMR) and suture rectopexy (SR). Methods MEDLINE, Embase, and the Cochrane Library were searched for studies reporting on the recurrence rates of complete rectal prolapse (CRP) or intussusception (IS) after SR and..

Published: 09/01/2021
Authors: Kearsey C, Rajaganeshan R

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Laser depilation as adjuvant therapy in prevention of recurrence of pilonidal sinus disease

Introduction Pilonidal disease (PD) is a chronic condition involving the sacrococcygeal area. It can have a significant impact on quality of life, social activities and occupation. Surgery is the mainstay of treatment. However, Laser depilation (LD) has been proposed as an adjunct to surgery and shown improved results in previous..

Published: 01/12/2020
Authors: Javed M, Kalaiselvan R, Rajaganeshan R

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Laser depilation as adjuvant therapy in prevention of recurrence of pilonidal sinus disease:

Introduction Pilonidal disease (PD) is a chronic condition involving the sacrococcygeal area. It can have a significant impact on quality of life, social activities and occupation. Surgery is the mainstay of treatment. However, Laser depilation (LD) has been proposed as an adjunct to surgery and shown improved results in previous..

Published: 15/07/2020
Authors: Liyanage A, Javed M, Kalaiselvan R, Rajaganeshan R

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Is it time for colorectal surgeons to follow the gynaecologists when removing left sided specimens?

Purpose To analyze different extraction sites for specimen extraction following left sided colorectal resections and risk for developing an IH. Methods Retrospective analysis of 107 patients undergoing laparoscopic left sided colorectal resections. Patients were divided into 3 groups based on extraction sites; midline, transverse (right or left) or pfannenstiel incisions. Data regarding..

Published: 15/07/2020
Authors: Javed M, Thomas E, West C, Chadwick M, Samad A, Rajaganeshan R

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What is the fate of an Ostomy following Emergency Laparotomy?

Purpose To analyse outcomes of patients undergoing emergency laparotomy and stoma formation particularly: stoma reversal, stoma associated complications (SAC) and cost implications. Methods Retrospective analysis of 57 patients identified from NELA database between January 2014 and December 2015. Results Median age was 72 years (IQR: 60–82), M:F = 25:32. The median time duration between admission and..

Published: 15/07/2020
Authors: Javed M, Ting L, Appleton ND, Chadwick M, Rajaganeshan R, Kalaiselvan R

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Overall survival of elderly colorectal cancer (CRC) patients

Purpose Advances in surgical techniques and perioperative care have improved cancer‐related outcomes. This study aims to describe the outcomes of elderly who had curative surgery or symptomatic management for CRC. Methods Retrospective study of consecutive CRC patients between 2014 to 2016 in a DGH, who were 70 years old or above. Demographic..

Published: 15/07/2020
Authors: Javed M, Airey G, Kearsey C, Samad A, Chadwick M, Rajaganeshan R

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Laser depilation as adjuvant therapy in prevention of recurrence of pilonidal sinus disease

Abstract Introduction Pilonidal disease is a chronic condition involving the sacrococcygeal area. It can have a significant impact on quality of life, social activities and occupation. Surgery is the mainstay of treatment. However, laser depilation has been proposed as an adjunct to surgery and has shown improved results in some..

Published: 17/04/2020
Authors: Liyanage A, Javed M, Defty C, Shaaban H, Kalaiselvan R, Rajaganeshan R

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Co-relation between clinical assessment, CT and intra-operative findings in emergency laparotomy. Is it time to rethink the algorithm?

Aims Although clinical diagnosis has essential value in an emergency setting, CT (computed tomography) has become the central tool of diagnosis to aid the need for emergency laparotomy. Delay in CT can often drastically alter the outcome, especially in patients over the age 60. We aimed to assess if initial clinical..

Published: 01/09/2019
Authors: Patnam V, Altaf K, Holdsworth J, Muttoni E, Rajaganeshan R

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P Th A.13 Video-assisted sinus surgery (VASS): New technique for treatment of surgical site sinus: A case series

Introduction Sinus formation after a procedure is a recognised complication. While most settle without requiring any treatment, many can continue to cause persistent symptoms. These have always been managed by exploration of the sinus tract under general anaesthetic, laying open, excision of the tract or debridement. Results post-surgery may not..

Published: 01/09/2019
Authors: Altaf K, Hajnik J, Patnam V, Rajaganeshan R

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SP 5.9- Clinical and cost effectiveness of CT scan as first lineinvestigation in diagnosis and treatment of acute abdominal pain – Is it time to change?

Background Abdominal x-ray (AXR) is currently used as a first line radiological investigation in assessing acute abdominal pain, often followed by a CT scan, which may delay diagnosis and treatment.We aimed to assess if AXR was needed at all in assessing these patients and its impact on patient outcomes...

Published: 01/09/2019
Authors: Altaf K, Muttoni E, Holdsworth J, Patnam V, Rajaganeshan R, MacDonald S

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Short-term outcomes of endoscopic pilonidal sinus treatment

​Kalaiselvan, R; Liyanage, A; Rajaganeshan, R. (2019). Short-term outcomes of endoscopic pilonidal sinus treatment. Annals of the Royal College of Surgeons of England. 5, p1-4. Introduction : Endoscopic treatment for pilonidal disease was initially described by Meinero in 2013. This minimally invasive technique has both technical and aesthetic advantages. The diagnostic application helps..

Published: 13/08/2019
Authors: Kalaiselvan R, Liyanage A, Rajaganeshan R

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Video-assisted anal fistula treatment: a high volume unit initial experience

​ Introduction: Perianal fistulas are a common problem. Video-assisted anal fistula treatment is a new technique for the management of this difficult condition. We describe our initial experience with the technique to facilitate the treatment of established perianal fistulas. Methods: We reviewed a prospectively maintained database relating to consecutive patients undergoing..

Published: 04/01/2018
Authors: Appleton ND, Chadwick M, Cheung F, Kalaiselvan R, Nicholson J, Rajaganeshan R, Rout S, Samad A

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Video Assisted Peri-anal Abscess Treatment (VPAT+) - Video Vignette

Abstract: We submit a video vignette describing how to perform a video-assistant peri-anal abscess drainage plus insertion of a draining seton. We have been using this technique within the NHS for two years successfully to manage acute perianal abscesses  Rajaganeshan, R. and Nicholson, J. A.. (2017). Video Assisted Peri-anal Abscess Treatment (..

Published: 02/01/2018
Authors: Nicholson J, Rajaganeshan R

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Laparoscopic ventral mesh rectopexy for rectal prolapse using veritas mesh

​ Introduction Rectal prolapse and obstructive defecation syndrome are life altering conditions, common across the age spectrum. When previously considered unfit for open abdominal surgery, elderly patients have tended to undergo perineal procedures, known to have higher failure rates. The laparoscopic ventral mesh rectopexy (Lap-VMR) allows all patients to benefit from..

Published: 16/08/2017
Authors: Fretwell VL, Brannigan K, Downes C, Rajaganeshan R, Chadwick M

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P427 Quality of life and outcomes following video assisted anal fistula treatment

Aim Video assisted anal fistula treatment (VAAFT) is a novel technique. We performed a prospective longitudinal study with the aim of evaluating outcomes and how quality of life was affected with this treatment. Method Patients undergoing VAAFT were entered into a prospective database. A longitudinal study design was employed. Data..

Published: 17/05/2017
Authors: , Rout S, Scott M, Samad A, Chadwick M, Rajaganeshan R

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Endoscopic pilonidal abscess treatment: a novel approach for the treatment of pilonidal abscess

​Introduction Pilonidal abscess is a common surgical emergency. Conventional treatment with incision and drainage is associated with significant postoperative morbidity. We report our initial experience of using minimally invasive endoscopic technique for the treatment of pilonidal abscesses, referred to as endoscopic pilonidal abscess treatment (EPAT). Materials and Methods A prospective..

Published: 14/03/2017
Authors: Jain Y, Javed M, Singh S, Rout S, , Rajaganeshan R

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Comparison of conventional incision and drainage for pilonidal abscess versus novel endoscopic pilonidal abscess treatment (EPAT)

​Javed, MA. et. al. (2016).Comparison of conventional incision and drainage for pilonidal abscess versus novel endoscopic pilonidal abscess treatment (EPAT). Techniques in Coloproctology . 20 (12), 871-873.

Published: 02/03/2017
Authors: Javed M, Singh S, Fowler H, Jain Y, Scott M, Rajaganeshan R

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Pilot study of video assisted anal fistula treatment

​ Abstract Introduction Video-assisted anal fistula treatment (VAAFT) is a minimally invasive, sphincter-preserving procedure with low morbidity. It was the aim of this prospective study to analyse both the feasibility and preliminary results of video-assisted anal fistula treatment (VAAFT) combined with advancement flap repair for anal fistula. Method  The procedure involves..

Published: 19/07/2016
Authors: Ormsby N, Rajaganeshan R

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PTU-233 Transanal haemorrhoidal dearterialization (THD) and targeted mucopexy for haemorrhoids

​ Introduction  This study aims to evaluate the efficacy of transanal haemorrhoidal dearterialization and Mucopexy (THD+Mpx) in the treatment of symptomatic haemorrhoids and to identify the factors predicting failure for an effective mid-term outcome. Method  Two hundred and fifteen patients affected by Grade II (27, 13%), III (145, 69%) and IV (39, 18%) symptomatic haemorrhoidal disease..

Published: 19/07/2016
Authors: Ormsby N, Singh S, Chadwick M, Scott M, Samad A, Rajaganeshan R

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PTH-306 R1 rectal cancer: an analysis of survival

​ Introduction  Evidence has shown that a positive resection margin (R1) is a key determinant of subsequent local recurrence and a poor prognostic factor in rectal cancer. The aim of this study was to evaluate the outcomes of patients with R1 resection of rectal cancer. Method  Retrospective study of all patients..

Published: 19/07/2016
Authors: Ormsby N, Chadwick M, Samad A, Scott M, Rajaganeshan R

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PWE-336 Outcomes of colorectal cancer resections in patients with multiple co-morbidities and advanced tumours

​ Introduction  Comorbid patients with advanced tumours constitute a rapidly growing segment of patients undergoing colorectal cancer resection, but their outcomes remain understudied and under-reported. Our aims were to analyse outcomes of high risk patients with advanced tumours undergoing curative colorectal resections compared with a similar cohort 2 decades younger. Method  Data..

Published: 19/07/2016
Authors: Garry J, Ormsby N, Scott M, Samad A, Rajaganeshan R

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Do we practice what we preach

​ Background & Aims There is a lack of conclusive long-term studies evaluating risk and benefit in the surgical management of patients who show a complete pathological response following radiotherapy in rectal cancer. The trend in practice is becoming increasingly conservative. We questioned whether increased age and/or comorbidity influenced management when..

Published: 19/07/2016
Authors: Ormsby N, Rajaganeshan R

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Emergency colorectal cancer: Primary care input

​ Introduction Higher morbidity and mortality is seen in patients with colorectal cancer (CRC) who present as an emergency. A study was performed to assess the pre-admission symptoms experienced by such patients, and time taken to referral. Method A retrospective analysis of all CRC patients presenting as an emergency to a..

Published: 19/07/2016
Authors: Rajaganeshan R, Scott M

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Correlation and diagnostic accuracy of CT in the acute surgical

​ Aim  CT in the acute surgical presentation has significantly increased with technological advancement and availability. Emergency CT is reported by the on call radiologist of varying seniority. We undertook a retrospective study to compare the correlation with the initial senior clinicians' diagnosis and the eventual laparotomy findings.  Method Retrospective data..

Published: 19/07/2016
Authors: Rajaganeshan R, Wellens T

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Is clinical examination alone becoming obsolete in modern surgic

​ Aim Computed Tomography (CT) is the radiological investigation of choice for the majority of acute surgical admissions with abdominal pain. Accuracy has been repeatedly reported at over 95% in studies since 2002. A retrospective analysis was performed to compare a senior clinician's bedside diagnosis with that of emergency CT. Method Retrospective review..

Published: 19/07/2016
Authors: Rajaganeshan R, Wellens T

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St Helens Community Staff

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Knowsley Community Staff

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Halton Community Staff

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North West Boroughs Community Health Staff

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