1. International expert consensus guidance on indications, implementation and quality measures for transanal total mesorectal excision
- Author
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Mark Katory, Teresa deBeche-Adams, Danilo Miskovic, Hongwei Yao, Mark Whiteford, Shady Ashamalla, Elena Vikis, Willem A. Bemelman, Tsuyoshi Konishi, Nicola Fearnhead, Sergio Araujo, Walter Brunner, Antonino Spinelli, Ichiro Takemasa, Eric Rullier, Quentin Denost, Jae Hwan Oh, Andrew Stevenson, Stephen Bell, Masaaki Ito, N. C. Buchs, Jos Kleijnen, Bert Houben, Patricia Sylla, Frederic Ris, Gabriela Möslein, Elisabeth McLemore, Michel Adamina, Janindra Warusavitarne, Alexander Heriot, Nader Francis, Zhongtao Zhang, Justin Maykel, Roel Hompes, Felix Aigner, Gustavo Rossi, Marta Penna, Alberto Arezzo, Park Sung Chan, André D'Hoore, J. Knol, Jared Torkington, Isacco Montroni, Gerald Seitinger, Minhua Zheng, John Marks, Werner Kneist, Eelco J. R. de Graaf, Sami A Chadi, Antonio Caycedo, Julian Hayes, Seong Hyeon Yun, Pieter J. Tanis, David Clark, Jurriaan B. Tuynman, Suguru Hasegawa, Rodrigo Oliva Perez, Carl J. Brown, Beatriz Martin-Perez, Buchs, Nicolas, Ris, Frédéric, Surgery, CCA - Cancer Treatment and Quality of Life, and AGEM - Amsterdam Gastroenterology Endocrinology Metabolism
- Subjects
medicine.medical_specialty ,Consensus ,health care facilities, manpower, and services ,media_common.quotation_subject ,Best practice ,education ,Delphi method ,Rectal surgery ,030230 surgery ,03 medical and health sciences ,0302 clinical medicine ,rectal surgery ,Humans ,Medicine ,Quality (business) ,Medical physics ,Rectal cancer ,rectal cancer ,health care economics and organizations ,Quality Indicators, Health Care ,Transanal Endoscopic Surgery ,media_common ,computer.programming_language ,ddc:617 ,Rectal Neoplasms ,business.industry ,TME ,Rectum ,Gastroenterology ,Expert consensus ,TaTME ,consensus ,guidance ,Total mesorectal excision ,Focus group ,Guidance ,Laparoscopy ,030211 gastroenterology & hepatology ,business ,computer ,Delphi round ,Delphi - 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.
- Published
- 2020