Ecoendoscopia brônquica: Aspectos práticos e aplicabilidade clínica

Abstract

Endobronchial ultrasound (EBUS) has become a major advance in bronchoscopy. Substantial scientific evidence has confirmed its usefulness in lung cancer diagnosis and staging, as well as in other clinical settings. It is of growing importance that endoscopists perform and interpret this imaging method accurately, in order to optimize diagnosis and treatment of their patients. The present article provides a practical and comprehensible review of the two EBUS systems currently available and its main clinical indications.

Endobronchial ultrasound-guided transbronchial needle aspiration in diagnosing mediastinal lymphadenopathy

“…[89] Apart from providing structural information about the airway wall and surrounding structures, central and peripheral lung histological specimens can be obtained under sonographic guidance improving diagnostic and patient management. [101112] EBUS in a setup already using bronchoscopy and the training is a very cost-effective, feasible, and highly effective mode to evaluate mediastinal lymphadenopathy.…”

Endoscopic ultrasound-guided biopsies for mediastinal lesions and lymph node diagnosis and staging

“…Equipment costs (especially disposable needles) and the learning curve for use of the technique are highlighted as the main difficulties that EBUS will still have to face before achieving greater availability and widespread use 1. International and Brazilian experiences with EUS-FNA, on the other hand, have already demonstrated the method's ability to avoid surgical procedures (mediastinoscopy, videothoracoscopy or even exploratory thoracotomy) in a considerable number of patients—86.3% of cases in this study.…”

“…Endobronchial ultrasound (known as EBUS) has faced greater technical bottlenecks, related to the smaller diameters of the bronchoscope, its working channel, the patients' airways and, especially, the interface between the ultrasound and air 1. The first sectorial echobronchoscope was launched on the international market only in the middle of the first decade of 2000.…”

“…The importance and usefulness of EUS for the mediastinal staging of primary lung cancer has been well known since 1996 6. The main limitation of EUS is its inability to access the anterior mediastinum because of the interference of air present in the trachea 1,7,8…”

Cuidados de enfermagem em endoscopia brônquica ultrassónica

“…10 Para além das indicações diagnósticas, a EBUS assume um papel relevante na otimização de opções terapêuticas face a anomalias das estruturas brônquicas e alterações do lúmen das vias aéreas, no tratamento por laser, na colocação de endopróteses em estenoses malignas e na decisão das margens e definição de envolvimento carinal ou traqueal das lesões quando a opção é a resseção cirúrgica. 11 O facto das lesões próximas ou em contacto com a árvore traqueobrônquica serem acessíveis por esta técnica e o caráter minimamente invasivo do EBUS--TBNA, com valor diagnóstico comparável aos métodos cirúrgicos convencionais, têm contribuído para que esta técnica tenha ganhado relevância rapidamente e sido integrada nos procedimentos de rotina de investigação em centros médicos de referência.…”