Head and Neck Centre, University College London Hospitals NHS Trust, London, England, UK.
Department of Imaging, Royal National ENT and Eastman Dental Hospitals, University College London Hospital NHS Trust, London, England, UK.
J Laryngol Otol. 2023 Jun;137(6):704-708. doi: 10.1017/S002221512300021X. Epub 2023 Feb 23.
UK guidelines advocate 'one-stop' neck lump assessment for cancer referrals. This paper reports the pilot of a novel pre-clinic ultrasound pathway, presents outcomes, and discusses strengths and limitations in the context of the coronavirus disease 2019 pandemic.
Two-week-wait cancer referral patients with a neck lump were allocated a pre-clinic ultrasound scan followed by a clinic appointment. Demographic, patient journey and outcome data were collected and analysed.
Ninety-nine patients underwent ultrasound assessment with or without biopsy on average 8 days following referral. Patients were followed up on average 14.1 days (range, 2-26 days) after initial referral. At the first clinic appointment, 45 patients were discharged, 10 were scheduled for surgery, 12 were diagnosed with cancer, 6 were referred to another specialty and cancer was excluded in 19 patients. Retrospectively, four ultrasounds were performed unnecessarily.
Pre-clinic ultrasound scanning is an alternative to the one-stop neck lump pathway. This study demonstrates fewer clinic visits, faster diagnosis and a low proportion of unnecessary scans, whilst minimising face-to-face consultations and aerosol-generating procedures.
英国指南提倡对癌症转介进行“一站式”颈部肿块评估。本文报告了一种新的诊所前超声通路的试点情况，介绍了结果，并结合 2019 年冠状病毒病大流行的情况讨论了其优缺点。
将两周等待癌症转介的颈部肿块患者分配进行诊所前超声扫描，然后再进行诊所预约。收集并分析人口统计学、患者就诊流程和结果数据。
99 名患者平均在转介后 8 天进行了超声评估，包括或不包括活检。患者在初次转介后平均随访 14.1 天（范围为 2-26 天）。在第一次诊所就诊时，45 名患者被出院，10 名患者被安排手术，12 名患者被诊断为癌症，6 名患者被转介到其他专科，19 名患者排除了癌症。回顾性分析显示，有 4 次超声检查是不必要的。
诊所前超声扫描是一种替代一站式颈部肿块通路的方法。本研究表明，该方法减少了就诊次数，加快了诊断速度，同时降低了不必要扫描的比例，尽量减少了面对面咨询和产生气溶胶的程序。
