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Semin Respir Crit Care Med 2022; 43(04): 583-592
DOI: 10.1055/s-0042-1748764
Review Article

Interventional Pulmonology and Esophagus: Combined Endobronchial Ultrasound and Endoscopic Ultrasound for Mediastinal Staging

Sameeha Khalid
1   Department of Internal Medicine, University of California San Francisco (UCSF), Fresno, California
,
Pravachan Hegde
2   Department of Pulmonary and Critical Care, University of California San Francisco (UCSF), Fresno Medical Education Program, Advanced Interventional Thoracic, Endoscopy/Interventional Pulmonology, UCSF, Fresno, California
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Abstract

Endoscopic ultrasound (EUS) techniques in addition to endobronchial ultrasound (EBUS) can lead to diagnosis and complete accurate staging of the mediastinum in a single session. This allows for decreased health care costs, less delay in diagnosis and treatment, reduced patient discomfort, and decreased morbidity compared with invasive surgical staging techniques. In comparison to conventional mediastinoscopy, the cost-effectiveness and reduced complication profile of the endoscopic approach has made this a superior initial step in the staging and diagnosis of lung cancer. Moreover, compared with EBUS alone, combined EUS and EBUS has significantly increased yield, as well as diagnostic sensitivity making a combined approach preferable as the emerging gold-standard technique for initial minimally invasive mediastinal staging. We discuss the advantage of using EUS in combination with EBUS and highlight techniques, lymph node landmarks, utility in staging and restaging of the mediastinum, roles in diagnosing mediastinal infections and granulomatous lesions, and future directions in endosonography.

Keywords

endoscopic ultrasound - endobronchial ultrasound - esophagus


Publication History

Article published online:
16 May 2022

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