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International expert consensus guidance on indications, implementation and quality measures for transanal total mesorectal excision
Author(s) -
Roel Hompes,
Michel Adamina,
Felix Aigner,
Sérgio Eduardo Alonso Araújo,
Alberto Arezzo,
Shady Ashamalla,
Teresa deBeche-Adams,
Stephen Bell,
Willem A. Bemelman,
Carl J. Brown,
W Brunner,
Nicolas Buchs,
Antonio Caycedo,
Sami A. Chadi,
Park Sung Chan,
David Clark,
Quentin Denost,
André D’Hoore,
Nicola Fearnhead,
Nader Francis,
E. de Graaf,
Suguru Hasegawa,
Julian Hayes,
Alexander G. Heriot,
Bert Houben,
Masaaki Ito,
Mark Katory,
Jos Kleijnen,
Werner Kneist,
Joep Knol,
Tsuyoshi Konishi,
John Marks,
Beatriz Martín-Pérez,
Justin A. Maykel,
Elisabeth C. McLemore,
Danilo Mišković,
Isacco Montroni,
Gabriela Möslein,
Jae Hwan Oh,
Rodrigo Oliva Perez,
Marta Penna,
Frédéric Ris,
Gustavo Rossi,
Éric Rullier,
Gerald Seitinger,
Antonino Spinelli,
Andrew Stevenson,
Patricia Sylla,
Ichiro Takemasa,
Pieter J. Tanis,
Jared Torkington,
Jurriaan B. Tuynman,
Elena Vikis,
Janindra Warusavitarne,
Mark H. Whiteford,
Hongwei Yao,
Seong Hyeon Yun,
Zhongtao Zhang,
Minhua Zheng
Publication year - 2020
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/codi.15147
Subject(s) - medicine , total mesorectal excision , delphi , delphi method , medical physics , medical education , colorectal cancer , statistics , mathematics , cancer , computer science , operating system
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.