PDF(Pubmed)
Abstract：
Endobronchial ultrasound (EBUS) has long been a common diagnostic tool used in the diagnosis of pulmonary pathologies. In the last decade, increased interest has been shown in its usage via the oesophagus for sampling lesions inaccessible via the airways. We describe three cases in which we used this modality to biopsy lesions not visualised via conventional EBUS and which would be too risky to be attempted via a CT-guided biopsy with a high likelihood of complications. More focused education on using EBUS via the oesophagus for respiratory trainees could greatly improve overall clinical practice. It improves the diagnostic yield of lesions and prevents subsequent referral to gastrointestinal colleagues which may delay diagnosis especially during the COVID-19 pandemic as was the case in our patient cohort where services are already limited. EBUS, due to its smaller size, is less irritant to the upper airways and requires less sedation than endoscopic ultrasound (EUS) scopes. It is also shorter than an EUS scope improving manoeuvrability. Each of our cases resulted in early histological diagnosis and subsequent appropriate treatment.
摘要：
支气管内超声（EBUS）长期以来一直是诊断肺部病变的常用诊断工具。在过去的十年里，通过食管对无法通过气道进入的病变进行采样的使用已显示出越来越大的兴趣。我们描述了三种情况，在这些情况下，我们使用这种方式对无法通过常规EBUS可视化的病变进行活检，并且通过CT引导的活检尝试的风险太大，很可能会出现并发症。对呼吸学员通过食道使用EBUS的更集中的教育可以极大地改善整体临床实践。它提高了病变的诊断率，并防止了随后转诊给胃肠道同事，这可能会延迟诊断，特别是在COVID-19大流行期间，就像我们的患者队列一样，服务已经有限。EBUS,由于其尺寸较小，与内窥镜超声（EUS）相比，对上呼吸道的刺激性较小，需要的镇静作用较少。它也比EUS范围短，可以提高机动性。我们的每个病例都导致早期组织学诊断和随后的适当治疗。
