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International expert consensus guidance on indications, implementation and quality measures for transanal total mesorectal excision
- Source :
- Colorectal Disease, Vol. 22, No 7 (2020) pp. 749-755, Colorectal disease, 22(7), 749-755. Wiley-Blackwell
- Publication Year :
- 2020
- Publisher :
- Wiley, 2020.
-
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.
- 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
Subjects
Details
- ISSN :
- 14631318 and 14628910
- Volume :
- 22
- Database :
- OpenAIRE
- Journal :
- Colorectal Disease
- Accession number :
- edsair.doi.dedup.....6770464e2fe2966fc564c8c4674dac13