Endobronchial ultrasound is also called Endobronchial Ultrasound-guided Transbronchial Needle Aspiration (EBUS-TBNA)
It is a test that can show if:
- an abnormal looking area is cancer
- the size of the cancer
- the cancer has spread into other lung areas or outside the lung
This test uses a narrow flexible tube to look at the inside of the breathing tubes (airways) in your lungs. The tube has an ultrasound probe. It uses high frequency sound waves to create pictures of the lungs and structures outside the airway walls, such as the lymph nodes.
Your doctor can see any areas that look abnormal and take samples (biopsies) to test. You will have this test in the endoscopy unit. It can take around 40 minutes. You will have the test under local anaesthetic with sedation
Why do I need an EBUS-TBNA?
You might have this test after an x-ray or CT scan if your doctor has seen:
- an abnormal looking area on your lung
- enlarged lymph nodes
This test can help your doctor diagnose and stage lung cancer and mesothelioma.
What do I need to do to prepare for an EBUS-TBNA?
You’ll be given written instructions on how to prepare for your EBUS-TBNA. For example, they will ask you not to eat and drink for 4 hours before the test.
Take your usual medicines as normal unless your doctor tells you otherwise. If you take warfarin or other medication to thin your blood, you need to stop this before your test. Your doctor or specialist nurse will tell you when to stop them.
You will have sedation for your procedure, this does not put you to sleep but may make you feel drowsy. Following your procedure you will need to arrange for somebody to pick you up from the endoscopy department and to stay with you for 24 hours. You will not be able to drive, drink alcohol, look after small children by yourself, operate heavy machinery or sign any legal documents for 24 hours following your test.
What happens on the day?
Before the test
When you arrive at the endoscopy department the nurse will ask you some questions about your health and check your vital signs. This includes your blood pressure, heart and breathing rate, your oxygen level and weight. You’ll see your doctor who will explain what’s going to happen and ask you to sign a consent form. This is a good time to ask any questions you may have. You may need to change into a hospital gown, or you might be able to stay in your own clothes.
The nurse then takes you to the procedure room and will assist you to lie in the correct position for your test. The doctor will numb your throat using a local anaesthetic, this can make you cough; your eyes may water and you may have a bitter taste in your mouth. They may also inject a medicine into your neck to numb your airways to help with the procedure. You will also have a sedative which is given through a small tube into one of your veins (cannula). This will help you to relax and can make you feel sleepy, but you will be able to answer questions.
The nurse or doctor also places a mouthguard into your mouth to protect your teeth and the scope.
During the test
Your doctor puts the bronchoscope into your mouth through to your airways. This is a bit uncomfortable but it doesn’t last long. You can breathe normally. The doctor may spray some local anaesthetic directly into your airway via the scope, this again may make you cough. Your doctor then looks for anything abnormal and can take tissue samples (biopsies) to test. They can also take photographs of the inside of your airways. The nurse looking after you will monitor your blood pressure, heart rate and oxygen levels throughout the procedure.
After the test
Afterwards, you’ll feel sleepy. A nurse will continue to monitor you in the recovery area until you are awake enough to leave. You won’t be able to eat or drink anything until the local anaesthetic wears off, a minimum of 1 hour post procedure.. This is because your throat is too numb to swallow safely at first. This usually passes after about an hour.
The nurse will remove the cannula before you are ready to leave.
Going home
You can usually go home the same day. If you take blood thinners, your doctor or nurse will tell you when to restart them. This is usually the next day. Someone will need to collect you from the hospital and stay with you overnight because of the sedative. You will not be able to drive, drink alcohol, look after small children by yourself, operate heavy machinery or sign any important documents for 24 hours after your procedure. You will need to take things easy for a day or so. You might have a sore throat for a couple of days.
Possible risks
The possible risks include:
Bleeding
You might see a small amount of blood in your spit after the test. Let your doctor or nurse know if this doesn’t go away.
Chest infection
See your GP straight away if your phlegm (sputum) changes colour, you start feeling more breathless or you feel as though you have a temperature.
A collapsed lung (pneumothorax)
Air or gas can collect in the space around the lung and make it collapse, but this is rare. Contact a doctor if you become short of breath or have chest pain.
Inflammation or infection of the central part of the chest (mediastinitis)
Inflammation or infection of the central part of the chest (mediastinum) can happen. Symptoms include pain or discomfort in the centre of your chest. Contact your healthcare team if you have this. You will need to be admitted to hospital for treatment with antibiotics into a vein (intravenously).
Getting your results
You should get your results within 1 or 2 weeks. Contact your doctor if you haven’t heard anything after this time.
Waiting for test results or for further tests can be very worrying. You might have contact details for a specialist nurse and you can contact them for information if you need to. It may help to talk to a close friend or relative about how you feel.
