Bronchoscopy is a method that has been used in the diagnosis of lower respiratory tract and lung diseases for many years. With bronchoscopy, signs of the disease within the airways can be observed directly or indirectly, and samples can be taken from the diseased areas for different examinations. However, in many lung diseases that do not have an abnormality in the airways, namely in the bronchi, extra diagnostic interventions up to surgery are required. Some sampling methods taken from outside the bronchus without seeing it with a bronchoscope are not efficient enough.
In recent years, with the ultrasonography added to the bronchoscope device, it is now seen in diseases outside of the airways and has become easily sampled. With this method, Endobronchial Ultrasonography and EBUS method, many diseases such as enlarged lymph nodes or tumor adjacent to the bronchus, which cannot be diagnosed with standard bronchoscopy, can be easily and visually reached and suitable samples can be obtained from these.
What is EBUS?
Ultrasonography is a method of obtaining images by hitting and reflecting sound waves on different tissues and organs in the human body. In this method, ultrasonic sound waves are sent to the human tissue, and the sound waves that hit the tissue and reflect back to a certain extent according to the properties of the tissue are re-perceived and transformed into the image of the tissue. Bats are the best example of this system in nature, and in fact, these blind animals can perceive everything around them very clearly, even though they cannot see them by making sounds at frequencies that human ears cannot hear and by listening to the reflections of these sounds.
In the EBUS system, thanks to the ultrasonography unit placed at the end of the bronchoscope, the inside of the airway can be seen on the one hand, while the tissues and blood vessels behind the wall of the bronchus can be viewed very clearly with the ultrasound method. After the lymph node or tumor mass to be biopsied is seen by ultrasonography, a special needle is sent through the bronchoscope and a sample can be taken from this lymph node or mass under the ultrasonographic image. The first advantage of the method is that it enables biopsy to be taken visually and that it is definitely possible to reach the target. The second advantage is that the blood vessels can be viewed by ultrasonography, thus eliminating the risk of vascular injury.
In this method, bronchoscopic intervention is performed orally under local or general anesthesia. The procedure time is only 15-20 minutes compared to the normal bronchoscopy procedure. is prolonged.
Which diseases is used in the diagnosis of EBUS?
This method is used in the diagnosis of many diseases such as cancer, lymphoma, sarcoidosis, tuberculosis, infectious diseases that grow in the lymph nodes adjacent to the airways. In addition to the diagnosis of the disease in cancer patients, the success of this method in determining the stage of the disease is very high. With the use of this method, many patients can be protected from unnecessary surgeries and the diagnosis and staging of their diseases can be achieved with a painless procedure without incision and even hospitalization. It enables biopsy from lymph nodes in the chest cavity such as sarcoidosis and tuberculosis, and saves the patient from the application of other surgical methods at a very high rate. In cancer patients, it is the main factor in determining the correct staging and correct treatment policy. With this method, staging can be performed in a very important part of the patients (over 90%) and the mediastinoscopic method is only needed in 5-10% of the patients.
In our Chest Diseases Clinic, Endobronchial Ultrasound EB-1970UK (PENTAX Medical), HI Vision Preirus Ultrasound Diagnostic Sacanner (Hitachi Medical Co.) system has been put into service as an EBUS device.