Novel and innovative ways of increasing diagnosis are needed to diagnose cancers earlier in Wales, whilst not becoming burdensome on an already stretched health service.
Dr Hasan Haboubi
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 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 is not yet in use in Wales.
There are two main potential 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.
This project sees Dr Hasan Haboubi, Consultant Gastroenterologist in Cardiff and Vale, and Dr Dai Samuel, Consultant Hepatologist in Cwm Taff Morgannwg, deploy Olympus gastroscopes in dual site TNE clinics across a six month period to test and demonstrate the value of TNE in a Welsh health context.
The TNE trial clinics have now concluded at Llandough Hospital. They were operational between December 2021 and February 2022. At its midway point, the pilot has achieved a number of key outcomes including training five members of staff across two different health boards to be proficient in performing transnasal endoscopy and delivering an efficient diagnostic service for over 100 patients.
The pilot clinics are now beginning at the Royal Glamorgan Hospital, where they will run until the end of June 2022. Following (and dependent on) evaluation of the pilot, to aim is to action uptake of TNE across all health boards in Wales.
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