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EBUS procedure

This page was reviewed under our medical and editorial policy by

Maurie Markman, MD, President, Medicine & Science at CTCA.

This page was updated on November 4, 2022.

An endobronchial ultrasound bronchoscopy (EBUS) is a minimally invasive medical procedure that allows doctors to look inside the lungs using a flexible tube that’s inserted through the mouth and into the lungs. During an EBUS, doctors may obtain tissue samples using a technique called transbronchial needle aspiration (EBUS TBNA).

If an X-ray or CT scan identifies an abnormality in the lungs, an EBUS procedure may help detect:

  • Whether abnormal image is lung cancer 
  • How big the tumor is
  • Whether it’s spread to other parts of the lung or body

Although an EBUS is often used to help diagnose lung cancer, it may also be used as a diagnostic tool for other types of lung illnesses, including lung inflammation or infection.

EBUS procedure in lung cancer diagnosis

An EBUS TBNA, a tool used to help diagnose and stage lung cancer, may be used on patients following an abnormal X-ray or CT scan. It was developed as an alternative to the mediastinoscopy, since it allows for a more accurate diagnosis and is also considered safer because it may be performed using local, rather than general, anesthesia.

The EBUS procedure uses a long, narrow device called a bronchoscope, which is inserted into the body via the mouth and then passes down into the airways and lungs. At the end of the bronchoscope is a camera and ultrasound probe that allows doctors to get a clear image of the inside of the trachea and breathing tubes.

The ultrasound probe enables doctors to take tissue samples from the lymph nodes inside the chest, a part of the body known as the mediastinum, which is then viewed under a microscope to look for the presence of cancer cells. An EBUS is a more complex procedure than a traditional bronchoscopy.

What to expect during the procedure

The care team will give the patient instructions before the procedure. Generally, an EBUS takes around 45 minutes and is performed as an outpatient procedure. However, most patients stay in the hospital or outpatient center for two to four hours to account for preparation and recovery time. Patients typically go home the same day, but will need to arrange for a ride home.

For the procedure:

  • Patients undergo conscious sedation (an injection) to help them feel relaxed. During sedation, patients will remain awake but may feel drowsy.
  • To begin, patients lie down on an examination table.
  • The bronchoscope tube is then passed through the mouth and into the lungs.
  • The doctor examines the lining of the lungs through the camera and used the ultrasound to determine which samples of tissues to remove.
  • Post-procedure, patients are be taken to a recovery area before being discharged.

Once home, patients may be advised to rest for a day or two. Some patients may also feel hoarse or have a sore throat.

Benefits and risks of EBUS

The main benefit of an EBUS is that it’s an effective diagnostic tool that enables doctors to diagnose and stage lung cancer. If lung cancer is found, the information discovered during the EBUS procedure may help the patient’s medical team determine an appropriate treatment plan.

The EBUS procedure is also minimally invasive, which makes it easier for the patient. The alternative to an EBUS TBNA is a mediastinoscopy, which is performed under general anesthetic and also requires an incision under the breastbone to insert the mediastinoscope.

While EBUS is generally a safe and well-tolerated procedure, there are potential risks, including:

  • Chest infection: If patients notice that they’re running a temperature, feel out of breath or notice their phlegm has changed color, this may indicate a chest infection.
  • Bleeding: While a small amount of blood in the saliva or spit isn’t uncommon after an EBUS, if it doesn’t stop, the patient should call the doctor.
  • Collapsed lung: Although rare, it’s possible for the lung to collapse after an EBUS due to air or gas getting trapped in the air around the lung. Chest pain or shortness of breath may indicate a collapsed lung.
  • A need for additional oxygen: Some patients might require extra oxygen after an EBUS, which may slow down the recovery time.

If patients feel unwell at any point after the EBUS, they should call their doctor or seek medical attention immediately.

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