PT  - JOURNAL ARTICLE
AU  - F. Herth
AU  - H.D. Becker
AU  - J. LoCicero III
AU  - A. Ernst
TI  - Endobronchial ultrasound in therapeutic bronchoscopy
AID  - 10.1183/09031936.02.01642001
DP  - 2002 Jul 01
TA  - European Respiratory Journal
PG  - 118--121
VI  - 20
IP  - 1
4099  - http://erj.ersjournals.com/content/20/1/118.short
4100  - http://erj.ersjournals.com/content/20/1/118.full
SO  - Eur Respir J2002 Jul 01; 20
AB  - Endobronchial ultrasound (EBUS) has been introduced as an adjunct to diagnostic bronchoscopy as it allows evaluation of the submucosal and parabronchial structures. Its use in therapeutic bronchoscopy has not been assessed. A large observational study of the value of EBUS in therapeutic bronchoscopy is presented here. From January 1998–January 2001 all patients undergoing therapeutic bronchoscopy and EBUS were evaluated prospectively. Patient demographics, indication for bronchoscopy, interventional treatments used and changes in therapy as influenced by the use of EBUS were documented. A total 2,446 therapeutic bronchoscopies were performed. In 1,174 cases EBUS was used (29% mechanical tumour debridement, 20% airway stenting, 13% Neodymium:yttrium aluminium garnet (Nd:YAG) laser use, 23% argon plasma coagulation, 11% brachytherapy, 2% foreign body removal and 2% endoscopic abscess drainage). EBUS guided or changed therapy significantly in 43% of cases. Changes included adjustment of stent dimensions, termination of tumour debridement when nearing vessels, and referral for surgical interventions rather than endoscopic treatment. Complications associated with EBUS use were minimal. No patient undergoing EBUS guided tumour destruction experienced severe bleeding or fistula formation. In summary, endobronchial ultrasound was easily performed and changed or guided therapeutic decisions during therapeutic bronchoscopic procedures in a substantial number of cases. As this may result in better outcomes, it has become a standard adjunct in the authors practice.