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

Michel Adamina; Felix Aigner; Sergio Araujo; Alberto Arezzo; Shady Ashamalla; Teresa deBeche-Adams; Stephen Bell; Willem Bemelman; Carl Brown; Walter Brunner; Nicolas Buchs; Antonio Caycedo; Sami Chadi; Park Sung Chan; David Clark; Quentin Denost; André D'Hoore; Nicola Fearnhead; Nader Francis; Eelco de Graaf; Suguru Hasegawa; Julian Hayes; Alexander Heriot; Bert Houben; Masaaki Ito; Mark Katory; Jos Kleijnen; Werner Kneist; Joep Knol; Tsuyoshi Konishi; John Marks; Beatriz Martin-Perez; Justin Maykel; Elisabeth McLemore; Danilo Miskovic; Isacco Montroni; Gabriela Möslein; Jae Hwan Oh; Rodrigo Oliva Perez; Marta Penna; Frederic Ris; Gustavo Rossi; Eric Rullier; Gerald Seitinger; Antonino Spinelli; Andrew Stevenson; Patricia Sylla; Ichiro Takemasa; Pieter Tanis; Jared Torkington; Jurriaan Tuynman; Elena Vikis; Janindra Warusavitarne; Mark Whiteford; Hongwei Yao; Seong Hyeon Yun; Zhongtao Zhang; Minhua Zheng

doi:10.1111/codi.15147

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

Michel Adamina
, Felix Aigner
, Sergio Araujo
, Alberto Arezzo
, Shady Ashamalla
, Teresa deBeche-Adams
, Stephen Bell
, Willem Bemelman
, Carl Brown
, Walter Brunner
, Nicolas Buchs
, Antonio Caycedo
, Sami Chadi
, Park Sung Chan
, David Clark
, Quentin Denost
, André D'Hoore
, Nicola Fearnhead
, Nader Francis
, Eelco de Graaf

Suguru Hasegawa, Julian Hayes, Alexander Heriot, Bert Houben, Masaaki Ito, Mark Katory, Jos Kleijnen, Werner Kneist, Joep Knol, Tsuyoshi Konishi, John Marks, Beatriz Martin-Perez, Justin Maykel, Elisabeth McLemore, Danilo Miskovic, Isacco Montroni, Gabriela Möslein, Jae Hwan Oh, Rodrigo Oliva Perez, Marta Penna, Frederic Ris, Gustavo Rossi, Eric Rullier, Gerald Seitinger, Antonino Spinelli, Andrew Stevenson, Patricia Sylla, Ichiro Takemasa, Pieter Tanis, Jared Torkington, Jurriaan Tuynman, Elena Vikis, Janindra Warusavitarne, Mark Whiteford, Hongwei Yao, Seong Hyeon Yun, Zhongtao Zhang, Minhua Zheng

Department of Surgery

Research output: Contribution to journal › Article › peer-review

54 Scopus citations

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.

Original language	English
Pages (from-to)	749-755
Number of pages	7
Journal	Colorectal Disease
Volume	22
Issue number	7
DOIs	https://doi.org/10.1111/codi.15147
State	Published - 1 Jul 2020

Keywords

Consensus
guidance
rectal cancer
rectal surgery
TaTME
TME

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1111/codi.15147

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Adamina, M., Aigner, F., Araujo, S., Arezzo, A., Ashamalla, S., deBeche-Adams, T., Bell, S., Bemelman, W., Brown, C., Brunner, W., Buchs, N., Caycedo, A., Chadi, S., Sung Chan, P., Clark, D., Denost, Q., D'Hoore, A., Fearnhead, N., Francis, N., ... Zheng, M. (2020). International expert consensus guidance on indications, implementation and quality measures for transanal total mesorectal excision. Colorectal Disease, 22(7), 749-755. https://doi.org/10.1111/codi.15147

@article{78708ec0410c42fdb7ea9f99aacb99c9,

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

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 {\textquoteleft}dynamic{\textquoteright} and updated as new evidence emerges.",

keywords = "Consensus, guidance, rectal cancer, rectal surgery, TaTME, TME",

author = "Michel Adamina and Felix Aigner and Sergio Araujo and Alberto Arezzo and Shady Ashamalla and Teresa deBeche-Adams and Stephen Bell and Willem Bemelman and Carl Brown and Walter Brunner and Nicolas Buchs and Antonio Caycedo and Sami Chadi and \{Sung Chan\}, Park and David Clark and Quentin Denost and Andr{\'e} D'Hoore and Nicola Fearnhead and Nader Francis and \{de Graaf\}, Eelco and Suguru Hasegawa and Julian Hayes and Alexander Heriot and Bert Houben and Masaaki Ito and Mark Katory and Jos Kleijnen and Werner Kneist and Joep Knol and Tsuyoshi Konishi and John Marks and Beatriz Martin-Perez and Justin Maykel and Elisabeth McLemore and Danilo Miskovic and Isacco Montroni and Gabriela M{\"o}slein and Oh, \{Jae Hwan\} and Perez, \{Rodrigo Oliva\} and Marta Penna and Frederic Ris and Gustavo Rossi and Eric Rullier and Gerald Seitinger and Antonino Spinelli and Andrew Stevenson and Patricia Sylla and Ichiro Takemasa and Pieter Tanis and Jared Torkington and Jurriaan Tuynman and Elena Vikis and Janindra Warusavitarne and Mark Whiteford and Hongwei Yao and \{Hyeon Yun\}, Seong and Zhongtao Zhang and Minhua Zheng",

note = "Publisher Copyright: Colorectal Disease {\textcopyright} 2020 The Association of Coloproctology of Great Britain and Ireland",

year = "2020",

month = jul,

day = "1",

doi = "10.1111/codi.15147",

language = "English",

volume = "22",

pages = "749--755",

journal = "Colorectal Disease",

issn = "1462-8910",

publisher = "John Wiley and Sons Inc",

number = "7",

}

Adamina, M, Aigner, F, Araujo, S, Arezzo, A, Ashamalla, S, deBeche-Adams, T, Bell, S, Bemelman, W, Brown, C, Brunner, W, Buchs, N, Caycedo, A, Chadi, S, Sung Chan, P, Clark, D, Denost, Q, D'Hoore, A, Fearnhead, N, Francis, N, de Graaf, E, Hasegawa, S, Hayes, J, Heriot, A, Houben, B, Ito, M, Katory, M, Kleijnen, J, Kneist, W, Knol, J, Konishi, T, Marks, J, Martin-Perez, B, Maykel, J, McLemore, E, Miskovic, D, Montroni, I, Möslein, G, Oh, JH, Perez, RO, Penna, M, Ris, F, Rossi, G, Rullier, E, Seitinger, G, Spinelli, A, Stevenson, A, Sylla, P, Takemasa, I, Tanis, P, Torkington, J, Tuynman, J, Vikis, E, Warusavitarne, J, Whiteford, M, Yao, H, Hyeon Yun, S, Zhang, Z & Zheng, M 2020, 'International expert consensus guidance on indications, implementation and quality measures for transanal total mesorectal excision', Colorectal Disease, vol. 22, no. 7, pp. 749-755. https://doi.org/10.1111/codi.15147

TY - JOUR

T1 - International expert consensus guidance on indications, implementation and quality measures for transanal total mesorectal excision

AU - Adamina, Michel

AU - Aigner, Felix

AU - Araujo, Sergio

AU - Arezzo, Alberto

AU - Ashamalla, Shady

AU - deBeche-Adams, Teresa

AU - Bell, Stephen

AU - Bemelman, Willem

AU - Brown, Carl

AU - Brunner, Walter

AU - Buchs, Nicolas

AU - Caycedo, Antonio

AU - Chadi, Sami

AU - Sung Chan, Park

AU - Clark, David

AU - Denost, Quentin

AU - D'Hoore, André

AU - Fearnhead, Nicola

AU - Francis, Nader

AU - de Graaf, Eelco

AU - Hasegawa, Suguru

AU - Hayes, Julian

AU - Heriot, Alexander

AU - Houben, Bert

AU - Ito, Masaaki

AU - Katory, Mark

AU - Kleijnen, Jos

AU - Kneist, Werner

AU - Knol, Joep

AU - Konishi, Tsuyoshi

AU - Marks, John

AU - Martin-Perez, Beatriz

AU - Maykel, Justin

AU - McLemore, Elisabeth

AU - Miskovic, Danilo

AU - Montroni, Isacco

AU - Möslein, Gabriela

AU - Oh, Jae Hwan

AU - Perez, Rodrigo Oliva

AU - Penna, Marta

AU - Ris, Frederic

AU - Rossi, Gustavo

AU - Rullier, Eric

AU - Seitinger, Gerald

AU - Spinelli, Antonino

AU - Stevenson, Andrew

AU - Sylla, Patricia

AU - Takemasa, Ichiro

AU - Tanis, Pieter

AU - Torkington, Jared

AU - Tuynman, Jurriaan

AU - Vikis, Elena

AU - Warusavitarne, Janindra

AU - Whiteford, Mark

AU - Yao, Hongwei

AU - Hyeon Yun, Seong

AU - Zhang, Zhongtao

AU - Zheng, Minhua

PY - 2020/7/1

Y1 - 2020/7/1

N2 - 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.

AB - 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.

KW - Consensus

KW - guidance

KW - rectal cancer

KW - rectal surgery

KW - TaTME

KW - TME

UR - https://www.scopus.com/pages/publications/85087800220

U2 - 10.1111/codi.15147

DO - 10.1111/codi.15147

M3 - Article

C2 - 32441803

AN - SCOPUS:85087800220

SN - 1462-8910

VL - 22

SP - 749

EP - 755

JO - Colorectal Disease

JF - Colorectal Disease

IS - 7

ER -

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

Abstract

Keywords

UN SDGs

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