Actual role of endobronchial ultrasound (EBUS)

Many pathologies of the airway involve the bronchial wall and the parabronchial structures. The view of the endoscopist, however, is limited to the lumen and the internal surface of the airway. Processes within the airway wall and outside the airway can only be assessed by indirect signs. Especially in malignancies, this can be of decisive importance for the fate of the patient. Therefore, expanding the endoscopist’s view beyond the airway is essential. Endobronchial ultrasound (EBUS) and endobronchial ultrasound–transbronchial needle aspiration (EBUS-TBNA) are new diagnostic tools that are available on the market. They have great potential for diagnosis of mediastinal processes and staging of lung cancer. After discovering a lung cancer without extrathoracic metastases, the preoperative mediastinal check-up is of great importance in determining operability. The investigation of a suspected malignant adenopathy justifies a complete examination by mediastinoscopy or mediastinotomy, which are considered gold standards. EBUS-TBNA constitutes the recent evolution of TBNA, a method known for 20 years now but underused. The aim of this review is to highlight to the different techniques and to discuss the results of published trials.