Development and early outcomes of the national training initiative for transanal total mesorectal excision in the UK.
Rectal cancer
TaTME
national programme
training
Journal
Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland
ISSN: 1463-1318
Titre abrégé: Colorectal Dis
Pays: England
ID NLM: 100883611
Informations de publication
Date de publication:
07 2020
07 2020
Historique:
received:
01
09
2019
accepted:
11
02
2020
pubmed:
18
2
2020
medline:
19
8
2021
entrez:
18
2
2020
Statut:
ppublish
Résumé
Transanal total mesorectal excision (TaTME) has attracted substantial interest amongst colorectal surgeons but its technical challenges may underlie the early reports of visceral injuries and oncological concerns. The aim of this study was to report on the feasibility, development and the outcome of the national pilot training initiative for TaTME-UK. TaTME-UK was successfully launched in September 2017 in partnership with the healthcare industry and endorsed by the Association of Coloproctology of Great Britain and Ireland. This multi-modal training curriculum consisted of three phases: (i) set-up; (ii) selection of pilot sites; and (iii) formal proctorship programme. Bespoke Global Assessment Scoring (GAS) forms were designed and completed by both trainees and mentors. Data were collected on patient demographics, tumour characteristics and perioperative clinical and histological outcomes. Twenty-four proctored cases were performed by 10 colorectal surgeons from five selected pilot sites. Median operative time was 331 ± 90 (195-610) min which was reduced to 283 ± 62 (195-340) min in the final case. Independent performance (GAS score of 5) was achieved for most operative steps by case 5. There was one conversion (4.2%), but no visceral injuries. Pathological data confirmed no bowel perforation and intact quality of the mesorectal TME specimens with clear distal margin in all cases and circumferential margins in 23/24 cases (96%). This exploratory study demonstrates acceptable early outcomes in a small cohort suggesting that a competency-based multi-modal training programme for TaTME can be feasible and safe to implement at a national level.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
756-767Investigateurs
Steve Arnold
(S)
Dibyendu Bandyopadhyay
(D)
John Black
(J)
Ken Campbell
(K)
Michael Chadwick
(M)
Kendra Chase
(K)
Praminthra Chitsabesen
(P)
Mark Coleman
(M)
Stephen Dalton
(S)
Jaap Doeve
(J)
Charles Hendrickse
(C)
Mark Katory
(M)
Joep Knol
(J)
Lian Lee
(L)
David McArthur
(D)
Tony Miles
(T)
Danilo Miskovic
(D)
Paul Ng
(P)
Deborah Nicol
(D)
Ajai Samad
(A)
Anjay Talwar
(A)
Rajesh Thengungal Kochupapy
(RT)
Ivan Theobald
(I)
Henk Wegstapel
(H)
Nick West
(N)
Stephanie Wood
(S)
Greg Wynn
(G)
Dorin Ziyaie
(D)
Informations de copyright
Colorectal Disease © 2020 The Association of Coloproctology of Great Britain and Ireland.
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