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

UEG/EAES · 2022 · Europe

Source and licence

Authors: Marco Milone, Michel Adamina, Alberto Arezzo et al.
Title: UEG and EAES rapid guideline: Systematic review, meta-analysis, GRADE assessment and evidence-informed European recommendations on TaTME for rectal cancer
Journal: Surgical Endoscopy, 2022
DOI: 10.1007/s00464-022-09090-4
Licence: CC BY 4.0
Changes: Verbatim excerpts; formatting adapted

Full text retrieved 2026-10-27 from Europe PMC · PMC8921163

Licence statement of the original publication

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Recommendations

Verbatim, with grade of recommendation or strength of consensus where given.

Recommendation – TaTME versus laparoscopic TME

We suggest TaTME over laparoscopic TME if expertise is available.Weak recommendation

Recommendation – TaTME versus robotic TME

We suggest TaTME over robotic TME if expertise is available.Weak recommendation

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.

Supplementary Information: The online version contains supplementary material available at 10.1007/s00464-022-09090-4.

Contents of the original publication

The section headings of the original.

Objective
Methods
Steering group
Guideline panel
Guideline questions
Protocol
Rating the importance of outcomes
Setting minimal important differences
Search strategy
Study selection
Risk of bias assessment
Statistical analysis
Evidence tables
Evidence-to-decision framework
Developing recommendations
Results
Recommendation – TaTME versus laparoscopic TME
Recommendation – TaTME versus robotic TME
Discussion
Implications for policy makers
Implications for healthcare professionals
Implications for patients
Implications for researchers
Monitoring
Validity period
Update
Conclusion

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