EAES Rapid Recommendation Update Protocol: TaTME for Rectal Cancer – With ESCP and ESGAR Participation

Abstract

Introduction

Transanal total mesorectal excision (TaTME) was developed to overcome anatomical constraints related to TME. The European Association of Endoscopic Surgery (EAES) released clinical recommendations to support gastrointestinal surgeons in the treatment of rectal cancer, but contemporary evidence is available.

Questions

1. Should patients receive TaTME or laparoscopic TME (laTME) for the surgical treatment of patients with low- or mid-rectal cancers? 2. Should patients receive TaTME or robotic TME (roTME) for the surgical treatment of patients with low- or mid-rectal cancers?

Methods

We will develop a rapid guideline update on the surgical management of low- and mid-rectal cancers with TaTME compared to TME. Guideline development will begin with a systematic review and meta-analysis performed by our systematic review and statistical analysis groups, followed by appraisal of the certainty of the evidence, and an in-person consensus meeting among an international, multidisciplinary expert panel using a structured evidence-to-decision framework. The panel will consist of six general surgeons, a radiologist, a pathologist, two patient representatives, and two external advisors. Following the consensus meeting, recommendations will be finalized through a Delphi consensus process. This guideline will adhere to methodological standards according to GIN, GRADE, and AGREE-S. Conflicts of interest will be declared by all participating members and addressed before guideline development. This clinical practice guideline will be presented at international congresses and published in the journal of Surgical Endoscopy & Other Interventional Techniques.