[Endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) for the evaluation of the mediastinum].

Endobronchial ultrasound (EBUS) is a promising new modality first introduced in the early 1990s. The radial probe EBUS was initially developed seeking for high resolution imaging of processes within the airway wall and also outside the airways. The radial probe EBUS guided transbronchial needle aspiration (TBNA) has increased the yield of TBNA of mediastinal lymph nodes. However it was still not a real-time procedure with target visualization. To overcome these problems, a new convex probe EBUS (CP-EBUS) with ability to perform real-time EBUS guided TBNA (EBUS-TBNA) was developed in 2002. EBUS-TBNA can be used for 1 - lymph node staging in lung cancer patients, 2 - diagnosis of intrapulmonary tumors, 3 - diagnosis of unknown hilar and/or mediastinal lymphadenopathy, and 4 - diagnosis of mediastinal tumors. A total of 800 procedures have been performed at the Department of Thoracic Surgery, Chiba University, using the CP-EBUS. The procedure is safe with minimal complications. It is especially useful for lymph node staging of lung cancer patients with a high diagnostic yield. EBUS-TBNA can also be used for the diagnosis of mediastinal tumors or mediastinal lymphadenopathy which may be very difficult to diagnose by other minimal-invasive modalities. EBUS-TBNA is a novel approach that is safe and has a good diagnostic yield.