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Canadian taTME expert collaboration (CaTaCO) position statement.

Antonio Caycedo-Marulanda1,2, Carl J Brown3,4, Sami A Chadi5,6

  • 1Kingston General Hospital, 76 Stuart Street, Kingston, ON, K7L 2V7, Canada. Antonio.Caycedo@kingstonhsc.ca.

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|June 7, 2020
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Summary

Transanal total mesorectal excision (taTME) is a complex rectal cancer surgery. Safe adoption requires specific guidelines for surgical setting, surgeon expertise, patient selection, and quality assurance.

Keywords:
Expert collaborationImplementationPosition statementSafetyTransanal total mesorectal excision

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Area of Science:

  • Colorectal Surgery
  • Surgical Oncology
  • Minimally Invasive Procedures

Background:

  • Transanal total mesorectal excision (taTME) is a novel surgical technique for rectal cancer.
  • It offers potential solutions for challenging distal pelvis access but faces safety concerns.
  • Canadian surgeons established a collaborative to develop guidelines for safe taTME adoption.

Purpose of the Study:

  • To provide expert opinion on the safe adoption and supervision of taTME in Canada.
  • To establish guidelines based on available evidence and author experience.
  • To address the need for a unified approach to taTME among Canadian rectal cancer surgeons.

Main Methods:

  • A multicentric collaborative, The Canadian taTME expert Collaboration, was established.
  • Surgeons from 8 major Canadian centers met to develop a position statement.
  • The Delphi methodology was employed over 4 rounds to reach consensus.

Main Results:

  • The position statement emphasizes the technical complexity and potential morbidity of taTME.
  • Key domains addressed include surgical setting, surgeon requirements, patient selection, and quality assurance.
  • A unified approach is crucial for managing taTME's challenges.

Conclusions:

  • Transanal total mesorectal excision is technically demanding with significant morbidity risks.
  • While outcomes have some uncertainty, safe adoption is achievable.
  • Meeting specific requirements across defined domains is essential for successful taTME implementation.