TBA (26S171)

Time to Adopt Transnasal Endoscopy: A retrospective evaluation of performance and clinical outcomes in 523 TNE procedures in St James Hospital, Dublin

Author(s)

Eilis McCarthy, Finbar MacCarthy, Emer Stone, Margaret Taylor, Laura Tier, Sharon Hough, David Prichard, on behalf of the endoscopy unit at SJH

Department(s)/Institutions

Endoscopy Dept, St James' Hospital

Introduction

Transnasal endoscopy (TNE) is an unsedated alternative to conventional OGD. Concerns regarding image quality, missed pathology, biopsy adequacy and patient acceptability have inhibited widespread adoption. However, advances in endoscope technology have overcome these limitations and recent real-world data suggests non-inferiority.

Aims/Background

To assess the performance of TNE and evaluate its feasibility as an alternative to conventional OGD.

Method

A retrospective audit of all TNE procedures performed at St. James’ Hospital between July 2025 - January 2026

Results

523 procedures were performed over 6 months. Priority was 34% urgent and 66% routine. Mean age was 53.4 years and 52% were female. Proceduralists were consultants (17%), ANP (31%), and registrars (52%) – with no difference in success rates. Oesophageal intubation was successful in 96.4%, 12% by transoral route, and among these the completion rate was 97%. Physician-rated comfort score was 0-1 in 94%. Complications occurred in 2 patients (epistaxis and aspiration). Cancer was identified in 2% and 0.5% of patients with urgent and routine indications respectively. Average number of biopsy sites was 1.2 (0-8) and adequate biopsies were obtained in 98%. Retroflexion and D2 intubation were achieved in 92%. Following TNE, 46% were discharged to GP. Integrating TNE into an endoscopy list increased upper GI endoscopy productivity by 50% and in 6 months reduced procedure wait-time by 21 months.

Conclusions

TNE is safe, well-tolerated and enables reliable mucosal assessment while avoiding sedation-related risk. Integration can increase access to endoscopy for patients without infrastructure change.