Complete “Medical Mediastinoscopy” Under Conscious Sedation: A Prospective Blinded Comparison of Endoscopic and Endobronchial Ultrasound to Bronchoscopic Fine Needle Aspiration for Malignant Mediastinal Lymph Nodes

Abstract

Background: We have previously reported a retrospective study suggesting endobronchial ultrasound (EBUS) and endoscopic ultrasound (EUS) are superior to blind bronchoscopic (“Wang”) FNA for detection of malignant mediastinal lymph nodes (Wallace et al. DDW 2005). We now report a prospective, blinded trial comparing the accuracy and feasibility of each modality. We hypothesize that the combination of EBUS and EUS will allow complete mediastinal staging. Methods: Patients presenting with lung tumors and/or enlarged mediastinal lymph nodes underwent combined EUS-FNA, EBUS-FNA and bronchoscopy-FNA, under a single conscious sedation.