Publication

International expert consensus guidance on indications, implementation and quality measures for transanal total mesorectal excision

Journal Paper/Review - May 23, 2020

Units
Keywords
transanal total mesorectal excision, taTME
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Doi
Contact

Citation
TaTme Guidance Group representing the ESCP in collaboration with the ASCRS, ACPGBI, ECCO, EAES, ESSO, CSCRS, CNSCRS, CSLES, CSSANZ, JSES, SACP, SAGES, SBCP, Swiss-MIS, Brunner W. International expert consensus guidance on indications, implementation and quality measures for transanal total mesorectal excision. Colorectal Dis 2020; 22:749-755.
Type
Journal Paper/Review (English)
Journal
Colorectal Dis 2020; 22
Publication Date
May 23, 2020
Issn Print
1462-8910
Issn Electronic
1463-1318
Pages
749-755
Brief description/objective

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.