Brian J Mehigan

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BACKGROUND Surgical haemorrhoidectomy has a reputation for being a painful procedure for a fairly benign disorder. The circular transanal stapled technique for the treatment of haemorrhoids has the potential to offer a less painful rectal procedure in place of ablative perianal surgery. We compared the short-term outcome of the circular stapled procedure(More)
PURPOSE Total mesorectal excision offers the lowest reported rates of local recurrence for rectal cancer; however, the ability to perform total mesorectal excision laparoscopically remains unproven. The aim of this study was to assess the feasibility and adequacy of a totally laparoscopic total mesorectal excision for rectal cancer. METHODS A prospective(More)
OBJECTIVE To determine whether survival and recurrence after laparoscopic-assisted surgery for colorectal cancer is compromised by an initial laparoscopic approach. SUMMARY BACKGROUND DATA Laparoscopic colorectal resection for malignancy remains controversial 8 years after its first description. Fears regarding compromised oncologic principles and early(More)
Background: Attenuation of the immune response to surgery, as demonstrated with the laparoscopic approach to cholecystectomy, has potential benefits in patients undergoing laparoscopic colonic resection for malignancy. We aimed to study the perioperative immune response in patients undergoing laparoscopically assisted and open surgery for colorectal cancer.(More)
Fast-track surgery (FTS) is a set of protocols aimed to reduce the physiological burden of surgery thus improving outcomes. FTS aims to use evidence-based practice to reduce complications, improve post-operative quality of life and decrease hospital length of stay. This review seeks to examine the evidence base for protocols employed in colorectal surgery(More)
Management options for colorectal cancer have expanded in recent years. We estimated average lifetime cost of care for colorectal cancer in Ireland in 2008, from the health care payer perspective. A decision tree model was developed in Microsoft EXCEL. Site and stage-specific treatment pathways were constructed from guidelines and validated by expert(More)
The explosion in the use of therapeutic laparoscopy during the past decade has focused much research interest on finding a basic scientific support for the clinically apparent attenuation of the stress response to surgery. In particular, the potential impact that attenuation of the immune response to surgery may have on laparoscopy for the cure of(More)
BACKGROUND Laparoscopic colorectal surgery has increasingly become the standard of care in the management of both benign and malignant colorectal disease. We herein describe our experience with laparoscopy in the management of complications following laparoscopic colorectal surgery. METHODS Between November 2010 and July 2012, data were prospectively(More)
Those who have surmounted the learning curve for laparoscopic colorectal resection state that considerable numbers of highly selected cases should comprise a department’s early experience to ensure reliability of technique before routine implementation. The objective of this study was to determine how this advice may interrupt case flow. Details on all(More)
Injury to the spleen is a recognised complication of colorectal resections involving mobilisation of the splenic flexure. Bleeding from the spleen is difficult to control and not infrequently requires splenectomy with its attendant lifelong potential haematological and immunological complications. Furthermore, conversion from a laparoscopic to an open(More)