Controversies in endobronchial ultrasound

Area of Science:

• Pulmonology and Respiratory Medicine
• Gastroenterology and Hepatology (Endoscopy)
• Oncology

Background:

• Endobronchial ultrasound (EBUS) is a minimally invasive, accurate, and safe endoscopic technique.
• EBUS is crucial for evaluating mediastinal lymphadenopathy, masses, and centrally located lung tumors.
• Combined EBUS with transbronchial and transesophageal sampling enhances lung cancer staging, reducing surgical needs.

Purpose of the Study:

• To address persistent challenges and controversial issues surrounding Endobronchial Ultrasound (EBUS) application.
• To clarify optimal practices and training standards for EBUS procedures in lung cancer diagnosis.

Main Methods:

• Review of existing evidence and expert opinion on EBUS procedures.
• Discussion of controversial aspects including informed consent, comparison with standard bronchoscopy, optimal procedural techniques (positioning, sedation), use of balloons, and skill acquisition/competence assurance.

Main Results:

• EBUS significantly improves lung cancer staging and diagnosis of mediastinal conditions.
• Several key areas require further clarification and standardization for optimal EBUS utilization.
• The article presents a Pro-Con discussion to resolve these open questions.

Conclusions:

• EBUS is a valuable tool in diagnosing lung cancer and mediastinal pathologies.
• Standardization of EBUS procedures, informed consent, and training are essential for maximizing its benefits.
• Further research and consensus are needed to address current EBUS-related controversies.