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
N1 - © 2022. The Author(s).
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 -