Perspective and practice patterns of mediastinal staging among thoracic surgeons

Area of Science:

• Thoracic Surgery
• Surgical Oncology
• Diagnostic Imaging

Background:

• Accurate mediastinal staging is crucial for lung cancer treatment planning.
• Mediastinoscopy and endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration are primary staging techniques.
• Data on training and practice trends for these methods among thoracic surgeons are limited.

Purpose of the Study:

• To determine current training and practice patterns for mediastinal staging among US thoracic surgeons.
• To assess the impact of EBUS introduction on surgical practice trends.
• To evaluate surgeon preferences and perceived advantages/disadvantages of EBUS versus mediastinoscopy.

Main Methods:

• A 28-question survey was distributed to practicing thoracic surgeons in the United States.
• The survey queried demographic, training, and practice patterns related to mediastinoscopy and EBUS.
• Descriptive statistics were used to analyze the collected data.

Main Results:

• 87% of surveyed surgeons received EBUS training, and 70% perform it routinely.
• Surgeons preferring EBUS cited safety, broader access to lymph node stations, and avoidance of repeat procedures.
• Surgeons preferring mediastinoscopy cited perceived higher accuracy for lymphoma/sarcoidosis and frozen section capabilities.

Conclusions:

• Endobronchial ultrasound (EBUS) is frequently utilized by thoracic surgeons for mediastinal staging.
• Proficiency acquisition methods for EBUS vary significantly among surgeons.
• Dedicated EBUS training should be incorporated into thoracic surgery curricula, complementing existing mediastinoscopy training.