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Review
. 2024 Jan-Feb;13(1):6-15.
doi: 10.1097/eus.0000000000000034. Epub 2023 Dec 1.

Controversies in endobronchial ultrasound

Christoph F Dietrich  1 , Antonio Bugalho  2   3 , Silvia Carrara  4 , Paul Frost Clementsen  5   6 , Yi Dong  7 , Michael Hocke  8 , Shailesh Balasaheb Kolekar  9   10 , Lars Konge  5   9 , André Ignee  11 , Axel Löwe  12   13 , Christian Jenssen  12   13
Affiliations
Review

Controversies in endobronchial ultrasound

Christoph F Dietrich et al. Endosc Ultrasound. 2024 Jan-Feb.

Abstract

Endobronchial ultrasound (EBUS) is a minimally invasive highly accurate and safe endoscopic technique for the evaluation of mediastinal lymphadenopathy and mediastinal masses including centrally located lung tumors. The combination of transbronchial and transoesophageal tissue sampling has improved lung cancer staging, reducing the need for more invasive and surgical diagnostic procedures. Despite the high level of evidence regarding EBUS use in the aforementioned situations, there are still challenges and controversial issues such as follows: Should informed consent for EBUS and flexible bronchoscopy be different? Is EBUS able to replace standard bronchoscopy in patients with suspected lung cancer? Which is the best position, screen orientation, route of intubation, and sedation/anesthesia to perform EBUS? Is it advisable to use a balloon in all procedures? How should the operator acquire skills and how should competence be ensured? This Pro-Con article aims to address these open questions.

Keywords: EBUS; Lung cancer staging; Mediastinal masses.

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Conflict of interest statement

Christoph F. Dietrich is the coeditor-in-chief of the journal; Michael Hocke, Lars Konge, and Christian Jenssen are editorial board members. This article was subject to the journal's standard procedures, with peer review handled independently of the editors and their research group.

Figures

Figure 1
Figure 1
Olympus EBUS scope (BF-UC190F) with specific parameters for handling. EBUS: endobronchial ultrasound.
Figure 2
Figure 2
Comparison of field of view and image quality between the EBUS Videoscope EB 19-J10U and the Videobronchoscope EB 19-10 (PENTAX Medical, Hamburg, Germany) at the level of larynx (a1, a2). Comparison of field of view and image quality between the EBUS Videoscope EB 19-J10U and the Videobronchoscope EB 19-10 (PENTAX Medical). Visualization of the tracheal bifurcation (b1, b2). EBUS: endobronchial ultrasound.
Figure 3
Figure 3
EBUS scope through a laryngeal mask. Entrance through the esophagus (left image) and through the vocal cords into the tracheobronchial tree (right image). EBUS: endobronchial ultrasound.
Figure 4
Figure 4
High-pressure suction applied directly to the needle (as described by Tsaknis et al.[42]
See this image and copyright information in PMC

References

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