EBUS ( Endobronchial Ultrasound)

What is EBUS?

EBUS or endobronchial ultrasound is one of the newer bronchoscopic procedures. (See Bronchoscopy). It is helpful to sample growths in the lung and to sample glands in our chest cavity called lymph nodes. It is usually performed by a lung specialist. 

 

What are the types of EBUS?

EBUS procedures are generally of 2 types: Linear and Radial.

A Linear EBUS procedure is used generally for sampling lymph nodes. This is useful in the diagnosis of various cancers, infections etc. This consists of a long black tube with a camera and light source at the tip along with a small ultrasound probe. It is slightly bigger than the normal bronchoscope. The tube is generally inserted through the mouth and the ultrasound is used to find lymph nodes in the chest to take samples.

A radial EBUS procedure is slightly different. It is used to take samples of growths in the lung which usually can’t be reached with a normal bronchoscopy. It consists of a long thin wire with a ultrasound probe at its tip which is inserted through the bronchoscope to look for growths in the chest for sampling and diagnosis.

 

What are the steps to take before the procedure?

Usually the steps are quite similar to any Bronchoscopy procedure. 

A consent form is completed after explaining all the risks of the procedure. Certain medications especially those that thin the blood such as Aspirin are stopped a few days prior to the procedure. Do not forget to mention to your lung specialist if you are on any such medications as this could lead to unexpected delays or cancelling of your procedure. 

 Generally you are advised not to eat or drink 6 hours before your procedure. A family member or friend should be available on the day to drive you home as you are not allowed to drive on the day of the procedure.

 

What are the risks of these procedures?

Generally both Bronchoscopy and EBUS procedures are extremely safe and have minimal risk. 

Most of the possible complications are related to sedation provided during the procedure which include cough, spasm of the airways, drop in blood pressure, heart rhythm changes or drop in oxygen levels. Usually these are easily managed by the attending Anaesthetist and are not common. Procedure related complications are rare. Most commonly there can be a residual cough for 3 to 4 hours post procedure which usually resolves without any treatment. Occasionally patients can get a low grade fever in the first day after the procedure.

Risk of significant bleeding or lung collapse with these procedures is extremely low. Rarely there have been reported cases of an infection within the lymph nodes after sampling which was easily treated with antibiotics. Extremely rare cases of needle breakage and damage to the covering of the heart (pericardium) have also been reported in literature.

 

How long does the procedure take? When do we get results?

These procedures take slightly longer than a usual Bronchoscopy procedure. 

Timings can vary between 30 to 60 minutes. There is a recovery time of approximately 1 to 2 hours in the post operative room in theatre. Patients will be able to go home 3 to 4 hours post the procedure. 

Results take a few days depending on the nature of the tests performed. Some tests such as tests for Tuberculosis and some special stains for cancers may take longer.