UEG and EAES rapid guideline: Systematic review, meta-analysis, GRADE assessment and evidence-informed European recommendations on TaTME for rectal cancer

Marco Milone; Michel Adamina; Alberto Arezzo; Nona Bejinariu; Luigi Boni; Nicole Bouvy; F Borja de Lacy; Raphaëla C Dresen; Konstantinos Ferentinos; Nader K Francis; Joe Mahaffey; Marta Penna; George Theodoropoulos; Katerina Maria Kontouli; Dimitris Mavridis; Per Olav Vandvik; Stavros A Antoniou

doi:10.1007/s00464-022-09090-4

UEG and EAES rapid guideline: Systematic review, meta-analysis, GRADE assessment and evidence-informed European recommendations on TaTME for rectal cancer

Marco Milone^*, Michel Adamina, Alberto Arezzo, Nona Bejinariu, Luigi Boni, Nicole Bouvy, F Borja de Lacy, Raphaëla C Dresen, Konstantinos Ferentinos, Nader K Francis, Joe Mahaffey, Marta Penna, George Theodoropoulos, Katerina Maria Kontouli, Dimitris Mavridis, Per Olav Vandvik, Stavros A Antoniou

^*Corresponding author for this work

Research output: Contribution to journal › (Systematic) Review article › peer-review

Abstract

BACKGROUND: Evidence and practice recommendations on the use of transanal total mesorectal excision (TaTME) for rectal cancer are conflicting.

OBJECTIVE: We aimed to summarize best evidence and develop a rapid guideline using transparent, trustworthy, and standardized methodology.

METHODS: We developed a rapid guideline in accordance with GRADE, G-I-N, and AGREE II standards. The steering group consisted of general surgeons, members of the EAES Research Committee/Guidelines Subcommittee with expertise and experience in guideline development, advanced medical statistics and evidence synthesis, biostatisticians, and a guideline methodologist. The guideline panel consisted of four general surgeons practicing colorectal surgery, a radiologist with expertise in rectal cancer, a radiation oncologist, a pathologist, and a patient representative. We conducted a systematic review and the results of evidence synthesis by means of meta-analyses were summarized in evidence tables. Recommendations were authored and published through an online authoring and publication platform (MAGICapp), with the guideline panel making use of an evidence-to-decision framework and a Delphi process to arrive at consensus.

RESULTS: This rapid guideline provides a weak recommendation for the use of TaTME over laparoscopic or robotic TME for low rectal cancer when expertise is available. Furthermore, it details evidence gaps to be addressed by future research and discusses policy considerations. The guideline, with recommendations, evidence summaries, and decision aids in user-friendly formats can also be accessed in MAGICapp: https://app.magicapp.org/#/guideline/4494 .

CONCLUSIONS: This rapid guideline provides evidence-informed trustworthy recommendations on the use of TaTME for rectal cancer.

Original language	English
Pages (from-to)	2221-2232
Number of pages	12
Journal	Surgical endoscopy and other interventional techniques
Volume	36
Issue number	4
DOIs	https://doi.org/10.1007/s00464-022-09090-4
Publication status	Published - Apr 2022

Keywords

Clinical practice guideline
EAES
EXPERIENCE
GRADE
Rectal cancer
SHORT-TERM-OUTCOMES
SURGERY
TOTAL MESORECTAL EXCISION
TaTME
Transanal TME

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10.1007/s00464-022-09090-4Licence: CC BY

Cite this

Milone, M., Adamina, M., Arezzo, A., Bejinariu, N., Boni, L., Bouvy, N., de Lacy, F. B., Dresen, R. C., Ferentinos, K., Francis, N. K., Mahaffey, J., Penna, M., Theodoropoulos, G., Kontouli, K. M., Mavridis, D., Vandvik, P. O., & Antoniou, S. A. (2022). UEG and EAES rapid guideline: Systematic review, meta-analysis, GRADE assessment and evidence-informed European recommendations on TaTME for rectal cancer. Surgical endoscopy and other interventional techniques, 36(4), 2221-2232. https://doi.org/10.1007/s00464-022-09090-4

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title = "UEG and EAES rapid guideline: Systematic review, meta-analysis, GRADE assessment and evidence-informed European recommendations on TaTME for rectal cancer",

abstract = "BACKGROUND: Evidence and practice recommendations on the use of transanal total mesorectal excision (TaTME) for rectal cancer are conflicting.OBJECTIVE: We aimed to summarize best evidence and develop a rapid guideline using transparent, trustworthy, and standardized methodology.METHODS: We developed a rapid guideline in accordance with GRADE, G-I-N, and AGREE II standards. The steering group consisted of general surgeons, members of the EAES Research Committee/Guidelines Subcommittee with expertise and experience in guideline development, advanced medical statistics and evidence synthesis, biostatisticians, and a guideline methodologist. The guideline panel consisted of four general surgeons practicing colorectal surgery, a radiologist with expertise in rectal cancer, a radiation oncologist, a pathologist, and a patient representative. We conducted a systematic review and the results of evidence synthesis by means of meta-analyses were summarized in evidence tables. Recommendations were authored and published through an online authoring and publication platform (MAGICapp), with the guideline panel making use of an evidence-to-decision framework and a Delphi process to arrive at consensus.RESULTS: This rapid guideline provides a weak recommendation for the use of TaTME over laparoscopic or robotic TME for low rectal cancer when expertise is available. Furthermore, it details evidence gaps to be addressed by future research and discusses policy considerations. The guideline, with recommendations, evidence summaries, and decision aids in user-friendly formats can also be accessed in MAGICapp: https://app.magicapp.org/#/guideline/4494 .CONCLUSIONS: This rapid guideline provides evidence-informed trustworthy recommendations on the use of TaTME for rectal cancer.",

keywords = "Clinical practice guideline, EAES, EXPERIENCE, GRADE, Rectal cancer, SHORT-TERM-OUTCOMES, SURGERY, TOTAL MESORECTAL EXCISION, TaTME, Transanal TME",

author = "Marco Milone and Michel Adamina and Alberto Arezzo and Nona Bejinariu and Luigi Boni and Nicole Bouvy and {de Lacy}, {F Borja} and Dresen, {Rapha{\"e}la C} and Konstantinos Ferentinos and Francis, {Nader K} and Joe Mahaffey and Marta Penna and George Theodoropoulos and Kontouli, {Katerina Maria} and Dimitris Mavridis and Vandvik, {Per Olav} and Antoniou, {Stavros A}",

note = "{\textcopyright} 2022. The Author(s).",

year = "2022",

month = apr,

doi = "10.1007/s00464-022-09090-4",

language = "English",

volume = "36",

pages = "2221--2232",

journal = "Surgical endoscopy and other interventional techniques",

issn = "0930-2794",

publisher = "Springer, Cham",

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Milone, M, Adamina, M, Arezzo, A, Bejinariu, N, Boni, L, Bouvy, N, de Lacy, FB, Dresen, RC, Ferentinos, K, Francis, NK, Mahaffey, J, Penna, M, Theodoropoulos, G, Kontouli, KM, Mavridis, D, Vandvik, PO & Antoniou, SA 2022, 'UEG and EAES rapid guideline: Systematic review, meta-analysis, GRADE assessment and evidence-informed European recommendations on TaTME for rectal cancer', Surgical endoscopy and other interventional techniques, vol. 36, no. 4, pp. 2221-2232. https://doi.org/10.1007/s00464-022-09090-4

UEG and EAES rapid guideline: Systematic review, meta-analysis, GRADE assessment and evidence-informed European recommendations on TaTME for rectal cancer. / Milone, Marco; Adamina, Michel; Arezzo, Alberto et al.
In: Surgical endoscopy and other interventional techniques, Vol. 36, No. 4, 04.2022, p. 2221-2232.

Research output: Contribution to journal › (Systematic) Review article › peer-review

TY - JOUR

T1 - UEG and EAES rapid guideline

T2 - Systematic review, meta-analysis, GRADE assessment and evidence-informed European recommendations on TaTME for rectal cancer

AU - Milone, Marco

AU - Adamina, Michel

AU - Arezzo, Alberto

AU - Bejinariu, Nona

AU - Boni, Luigi

AU - Bouvy, Nicole

AU - de Lacy, F Borja

AU - Dresen, Raphaëla C

AU - Ferentinos, Konstantinos

AU - Francis, Nader K

AU - Mahaffey, Joe

AU - Penna, Marta

AU - Theodoropoulos, George

AU - Kontouli, Katerina Maria

AU - Mavridis, Dimitris

AU - Vandvik, Per Olav

AU - Antoniou, Stavros A

PY - 2022/4

Y1 - 2022/4

N2 - BACKGROUND: Evidence and practice recommendations on the use of transanal total mesorectal excision (TaTME) for rectal cancer are conflicting.OBJECTIVE: We aimed to summarize best evidence and develop a rapid guideline using transparent, trustworthy, and standardized methodology.METHODS: We developed a rapid guideline in accordance with GRADE, G-I-N, and AGREE II standards. The steering group consisted of general surgeons, members of the EAES Research Committee/Guidelines Subcommittee with expertise and experience in guideline development, advanced medical statistics and evidence synthesis, biostatisticians, and a guideline methodologist. The guideline panel consisted of four general surgeons practicing colorectal surgery, a radiologist with expertise in rectal cancer, a radiation oncologist, a pathologist, and a patient representative. We conducted a systematic review and the results of evidence synthesis by means of meta-analyses were summarized in evidence tables. Recommendations were authored and published through an online authoring and publication platform (MAGICapp), with the guideline panel making use of an evidence-to-decision framework and a Delphi process to arrive at consensus.RESULTS: This rapid guideline provides a weak recommendation for the use of TaTME over laparoscopic or robotic TME for low rectal cancer when expertise is available. Furthermore, it details evidence gaps to be addressed by future research and discusses policy considerations. The guideline, with recommendations, evidence summaries, and decision aids in user-friendly formats can also be accessed in MAGICapp: https://app.magicapp.org/#/guideline/4494 .CONCLUSIONS: This rapid guideline provides evidence-informed trustworthy recommendations on the use of TaTME for rectal cancer.

AB - BACKGROUND: Evidence and practice recommendations on the use of transanal total mesorectal excision (TaTME) for rectal cancer are conflicting.OBJECTIVE: We aimed to summarize best evidence and develop a rapid guideline using transparent, trustworthy, and standardized methodology.METHODS: We developed a rapid guideline in accordance with GRADE, G-I-N, and AGREE II standards. The steering group consisted of general surgeons, members of the EAES Research Committee/Guidelines Subcommittee with expertise and experience in guideline development, advanced medical statistics and evidence synthesis, biostatisticians, and a guideline methodologist. The guideline panel consisted of four general surgeons practicing colorectal surgery, a radiologist with expertise in rectal cancer, a radiation oncologist, a pathologist, and a patient representative. We conducted a systematic review and the results of evidence synthesis by means of meta-analyses were summarized in evidence tables. Recommendations were authored and published through an online authoring and publication platform (MAGICapp), with the guideline panel making use of an evidence-to-decision framework and a Delphi process to arrive at consensus.RESULTS: This rapid guideline provides a weak recommendation for the use of TaTME over laparoscopic or robotic TME for low rectal cancer when expertise is available. Furthermore, it details evidence gaps to be addressed by future research and discusses policy considerations. The guideline, with recommendations, evidence summaries, and decision aids in user-friendly formats can also be accessed in MAGICapp: https://app.magicapp.org/#/guideline/4494 .CONCLUSIONS: This rapid guideline provides evidence-informed trustworthy recommendations on the use of TaTME for rectal cancer.

KW - Clinical practice guideline

KW - EAES

KW - EXPERIENCE

KW - GRADE

KW - Rectal cancer

KW - SHORT-TERM-OUTCOMES

KW - SURGERY

KW - TOTAL MESORECTAL EXCISION

KW - TaTME

KW - Transanal TME

U2 - 10.1007/s00464-022-09090-4

DO - 10.1007/s00464-022-09090-4

M3 - (Systematic) Review article

C2 - 35212821

SN - 0930-2794

VL - 36

SP - 2221

EP - 2232

JO - Surgical endoscopy and other interventional techniques

JF - Surgical endoscopy and other interventional techniques

IS - 4

ER -