Department of Otolaryngology, Queen Elizabeth University Hospital, NHS Greater Glasgow and Clyde, Glasgow, Scotland, UK.
J Laryngol Otol. 2024 Mar;138(3):338-340. doi: 10.1017/S0022215123001500. Epub 2023 Aug 31.
Out-patient channelled endoscopic local anaesthetic biopsy reduces the time to diagnosis and wider use may improve cancer pathway times. This study aimed to assess the practice of ENT surgeons using channelled local anaesthetic biopsy.
A survey was distributed nationally, containing questions about out-patient local anaesthetic biopsy.
In total, 58 responses were returned; only 12 per cent of respondents ( = 7) used general anaesthetic biopsy. The advantages of local anaesthetic biopsy were: the avoidance of general anaesthetic for patients with poor performance scores (95 per cent, = 55) and faster cancer pathway times (91 per cent, = 53). Disadvantages were: clinics running late (29 per cent, = 17) and complications (24 per cent, = 14). The main barrier to using local anaesthetic was access to channelled flexible endoscopy (38 per cent, = 22), with 43 per cent ( = 25) reporting they were not using out-patient channelled endoscopes but would be interested in using them.
Surgeons are interested in using channelled endoscopic local anaesthetic biopsy, but they are limited by access to equipment. Increased use of channelled endoscopes may improve national cancer pathway times and avoid challenging general anaesthetics.
门诊经通道局部麻醉活检可缩短诊断时间,更广泛的应用可能会改善癌症诊治流程时间。本研究旨在评估耳鼻喉科外科医生使用经通道局部麻醉活检的情况。
在全国范围内发放了一份包含门诊局部麻醉活检相关问题的调查问卷。
共收到 58 份回复,仅有 12%的(7 人)受访者使用全身麻醉活检。局部麻醉活检的优势在于:为表现不佳的患者(95%,55 人)避免全身麻醉和更快的癌症诊治流程时间(91%,53 人)。劣势在于:门诊时间延迟(29%,17 人)和并发症(24%,14 人)。使用局部麻醉的主要障碍是无法获得经通道的软式内镜(38%,22 人),43%(25 人)的受访者表示他们没有使用门诊经通道内镜,但有兴趣使用。
外科医生有兴趣使用经通道内镜下局部麻醉活检,但受到设备获取的限制。更多地使用经通道内镜可能会改善全国癌症诊治流程时间,避免有挑战性的全身麻醉。