Endoscopy is critical to the diagnosis of oesophageal and gastric cancers, which are both in the top 10 of cancers with the worst mortality outcomes. Endoscopy can be particularly valuable in identifying pre-cancerous lesions and early cancers where the tumour is still amenable to curative treatment.
Transnasal endoscopy (TNE) is an upper gastrointestinal (GI) endoscopy method performed via the nose instead of the traditional method through the mouth, using a thinner endoscope. The practice has been adopted in some hospitals in England and widely in Scotland but prior to this work was not in use in Wales.
There are two main benefits of introducing TNE to the diagnostic pathway:
- Better patient outcomes - as the procedure is less invasive it is therefore more comfortable
- Improved efficiency - TNE can take less time and fewer resources, thus enabling more patients to be seen overall and can therefore contribute to reducing the growing backlog facing endoscopy services.
Cardiff & Vale & Cwm Taff Morgannwg University Health Boards
Dr Hasan Haboubi, Consultant Gastroenterologist in Cardiff & Vale, and Dr Dai Samuel, Consultant Hepatologist in Cwm Taff Morgannwg, led TNE clinics across a six month period (December 21 - June 2022) to test and demonstrate the value of TNE in a Welsh health context.
Following the conclusion of the trial clinics, both Cwm Taff Morgannwg and Cardiff & Vale have now introduced TNE to their patient pathway.
The findings from the implementation clinics in Cardiff & Vale have been published by the British Medical Journal and can be accessed here.
Powys Teaching Health Board
Led by Dr Ruth Corbally, TNE implementation clinics commenced in Powys Teaching Health Board in 2024 and are now transitioning into routine care within their patient pathway.
