The Surgical Management of Tuberculosis and Its Complications
Peter D O Davies, Stephen B Gordon, Geraint Davies in Clinical Tuberculosis, 2014
Endobronchial ultrasound (EBUS)-guided fine-needle aspiration biopsy of mediastinal nodes offers a less invasive alternative for sampling of the mediastinal nodes (http://guidance.nice.org.uk/IPG254). The procedure is being widely adopted by respiratory physicians and is reducing the practice of mediastinoscopy [5]. This procedure is very similar to flexible bronchoscopy and can be undertaken with conscious sedation or under general anaesthesia. The EBUS bronchoscope is similar in dimensions to a standard adult fibre-optic bronchoscope but has an ultrasound probe at its distal end. Proximal to the ultrasound probe, and at 30 degrees to the long axis of the bronchoscope, are a fibre-optic lens and a biopsy channel, through which a 22-G biopsy needle can be passed.
The Surgical Management of Tuberculosis and Its Complications
Lloyd N. Friedman, Martin Dedicoat, Peter D. O. Davies in Clinical Tuberculosis, 2020
Endobronchial ultrasound (EBUS)-guided fine-needle aspiration biopsy of mediastinal nodes offers a less invasive alternative for sampling of the mediastinal nodes (http://guidance. nice.org.uk/IPG254). The procedure is being widely adopted by respiratory physicians and is reducing the practice of mediastinoscopy.5 This procedure is very similar to flexible bronchoscopy and can be undertaken with conscious sedation or under general anesthesia. The EBUS bronchoscope is similar in dimensions to a standard adult fiber-optic bronchoscope but has an ultrasound probe at its distal end. Proximal to the ultrasound probe, and at 30 degrees to the long axis of the bronchoscope, are a fiber-optic lens and a biopsy channel, through which a 22-G biopsy needle can be passed.
The Respiratory System and Its Disorders
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss in Understanding Medical Terms, 2020
The fiberoptic bronchoscope is an instrument utilized for visual examination of the bronchi through the procedure of bronchoscopy and may be used to obtain bronchial brushings and biopsies. Mediastinoscopy is the examination of the mediastinum and its lymph nodes, particularly in suspected malignancy. Use of an endoscope to inspect the larynx is laryngoscopy. Thoracoscopy denotes examination of the pleural cavity. Fluoroscopy is a type of radiographic technique that allows visualization of the thoracic contents In a dynamic manner and provides a range of views.
Role of endobronchial ultrasound-guided transbronchial needle aspiration in lung cancer management
Published in Expert Review of Respiratory Medicine, 2019
Yuichi Sakairi, Takahiro Nakajima, Ichiro Yoshino
Mediastinoscopy is a method of obtaining tissue samples from the superior mediastinum for nodal staging [2] and it has become the gold standard method for nodal staging of lung cancer. In practice, the mediastinum is evaluated preoperatively by mediastinoscopy in only 27.1% of lung cancer patients, and among patients who undergo the procedure, only 46.6% of patients have documented evidence of lymph node biopsy material that is submitted for pathology [3]. The biggest issue regarding mediastinoscopy is its invasiveness; thus a decreasing trend was observed in the performance of nodal staging by mediastinoscopy in the United States from 2006 (14.6%) to 2010 (11.4%) [4]. In 2017, a large cohort study based on the society of thoracic surgeons database revealed that invasive staging, including mediastinoscopy, was conducted in only half of surgical patients, which was quite low in comparison to the estimated population [5].
Techniques for lung surgery: a review of robotic lobectomy
Published in Expert Review of Respiratory Medicine, 2018
Sophia Chen, Travis C. Geraci, Robert James Cerfolio
The preoperative evaluation of patients undergoing robotic lung resection is similar to patients undergoing planned VATS or open thoracotomy, including pulmonary function testing, cardiac stress testing in patients at risk of cardiovascular disease, and complete patient-specific staging [7,19]. Oncologic staging also involves a positron emission tomography–computed tomography (PET-CT) scan in most patients and in select patients, either brain magnetic resonance imaging (MRI) or CT (for symptomatic patients or for patients with large central adenocarcinomas). Mediastinal assessment is completed by endobronchial and esophageal ultrasound-guided fine needle aspiration and/or cervical mediastinoscopy, depending on the tumor size and experience of the institution [7]. From a respiratory point of view, the same criteria used for VATS apply for robotic lobectomy. Predicted postoperative forced expiratory volume and/or diffusing capacity of the lungs for carbon monoxide >40% of predicted is considered safe with acceptable morbidity and mortality [10].
Advantages and drawbacks associated with the use of endosonography in sarcoidosis
Published in Expert Review of Respiratory Medicine, 2023
Kuruswamy Thurai Prasad, Sahajal Dhooria, Valliappan Muthu, Inderpaul Singh Sehgal, Ashutosh Nath Aggarwal, Ritesh Agarwal
Mediastinoscopy has a very high (97–100%) sensitivity for stage I and II sarcoidosis [55,56]. However, it is a surgical procedure involving hospitalization, general anesthesia, a skin incision, and higher costs [57]. Mediastinoscopy is associated with a low but important complication rate [57]. A meta-analysis of mediastinoscopy vs. endosonographic procedures (for lung cancer) revealed a 7.9% incidence of major complications with the former vs. 1.1% with the latter [58]. Moreover, EBUS-TBNA when combined with endobronchial biopsy (EBB) and transbronchial lung biopsy (TBLB), or when performed using novel techniques such as the 19-gauge needle, EBUS-IFB, or EBMC, achieves a yield of 93% or higher [24,42,59,60]. Thus, the risks and cost of mediastinoscopy do not justify the marginal (about 5%) improvement in diagnostic sensitivity [56].
Related Knowledge Centers
- Biopsy
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- Mediastinum
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- Carina of Trachea
- Mediastinoscope