International expert consensus guidance on indications, implementation and quality measures for transanal total mesorectal excision. (13th July 2020)

• Record Type: Journal Article
• Other Names: Adamina Michel investigator.; Aigner Felix investigator.; Araujo Sergio investigator.; Arezzo Alberto investigator.; Ashamalla Shady investigator.; deBeche‐Adams Teresa investigator.; Bell Stephen investigator.; Bemelman Willem investigator.; Brown Carl investigator.; Brunner Walter investigator.; Buchs Nicolas investigator.; Caycedo Antonio investigator.; Chadi Sami investigator.; Sung Chan Park investigator.; Clark David investigator.; Denost Quentin investigator.; D'Hoore André investigator.; Fearnhead Nicola investigator.; Francis Nader investigator.; de Graaf Eelco investigator.; Hasegawa Suguru investigator.; Hayes Julian investigator.; Heriot Alexander investigator.; Houben Bert investigator.; Ito Masaaki investigator.; Katory Mark investigator.; Kleijnen Jos investigator.; Kneist Werner investigator.; Knol Joep investigator.; Konishi Tsuyoshi investigator.; Marks John investigator.; Martin‐Perez Beatriz investigator.; Maykel Justin investigator.; McLemore Elisabeth investigator.; Miskovic Danilo investigator.; Montroni Isacco investigator.; Möslein Gabriela investigator.; Oh Jae Hwan investigator.; Perez Rodrigo Oliva investigator.; Penna Marta investigator.; Ris Frederic investigator.; Rossi Gustavo investigator.; Rullier Eric investigator.; Seitinger Gerald investigator.; Spinelli Antonino investigator.; Stevenson Andrew investigator.; Sylla Patricia investigator.; Takemasa Ichiro investigator.; Tanis Pieter investigator.; Torkington Jared investigator.; Tuynman Jurriaan investigator.; Vikis Elena investigator.; Warusavitarne Janindra investigator.; Whiteford Mark investigator.; Yao Hongwei investigator.; Hyeon Yun Seong investigator.; Zhang Zhongtao investigator.; Zheng Minhua investigator.;
• Is Part Of: Colorectal disease. Volume 22:Number 7(2020)
• Page Start: 749
• Page End: 755
• Publication Date: 2020-07-13
• Subjects: Consensus -- guidance -- rectal cancer -- rectal surgery -- TaTME -- TME; Colon (Anatomy) -- Diseases -- Periodicals; Rectum -- Diseases -- Periodicals; 616.34
• DOI: 10.1111/codi.15147
• Languages: English
• ISSNs: 1462-8910

Abstract

Abstract: Aim: To provide dynamic guidance from a rigorous and up‐to‐date consensus on the safe implementation and application of transanal total mesorectal excision (TaTME) from an international panel of expert surgeons and educationalists supported by 14 international surgical societies. Method: An adapted Delphi method and focus group discussion approach was implemented for this consensus process, with expert advice from a guidelines methodologist. Statements were generated focusing on three main topics relating to the safe implementation of TaTME: (1) indications, (2) quality and outcome measures, (3) training and implementation of TaTME. Results: Five rounds of the Delphi consensus process were completed over a 13‐month period. A total of 56 surgeons experienced in TaTME and surgical education participated in this project. By Delphi round four, 80.0% or greater agreement was reached for all statements except for two, which were further reviewed during a fifth round. More complex cases that are likely to benefit from TaTME were identified, with the recommendation that they should be referred to TaTME expert centres. The most agreed upon definition of expert centres is outlined. Conclusion: We have provided a current framework of best practice related to implementation of TaTME. The statements are not indefinite and will continue to be 'dynamic' and updated as new evidence emerges.