UEG and EAES rapid guideline: Systematic review, meta-analysis, GRADE assessment and evidence-informed European recommendations on TaTME for rectal cancer
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...
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Veröffentlicht in: | Surgical endoscopy 2022-04, Vol.36 (4), p.2221-2232 |
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Format: | Artikel |
Sprache: | eng |
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Zusammenfassung: | 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
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Conclusions
This rapid guideline provides evidence-informed trustworthy recommendations on the use of TaTME for rectal cancer. |
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ISSN: | 0930-2794 1432-2218 1432-2218 |
DOI: | 10.1007/s00464-022-09090-4 |