Endobronchial ultrasound combines a bronchoscope with an ultrasound probe, so that structures lying outside the airway wall — lymph nodes and masses in the centre of the chest — can be seen and sampled with a needle under real-time guidance. EBUS in Rewari is available at Vaayu Care, performed by Dr. Ajit Yadav, who trained specifically in interventional pulmonology and EBUS.
Why EBUS matters
The centre of the chest, the mediastinum, contains lymph nodes that drain the lungs. Whether these nodes contain cancer determines the stage of a lung cancer — and stage determines whether surgery offers a cure or whether chemoradiotherapy or systemic treatment is the better route.
A CT or PET scan shows where nodes are and how active they look, but cannot say for certain what is in them. Enlarged nodes are often reactive rather than malignant, and normal-sized nodes sometimes contain cancer. Treating on imaging alone means some patients undergo surgery they cannot benefit from while others are denied surgery that could have cured them.
Before EBUS, sampling these nodes usually meant mediastinoscopy — a surgical procedure through an incision at the base of the neck, under general anaesthetic, with an inpatient stay. EBUS achieves the same result through the natural airway, under sedation, as a day case.
What EBUS is used for
- Staging lung cancer — systematic sampling of mediastinal and hilar lymph nodes
- Diagnosing a central lung mass that cannot be reached by ordinary bronchoscopy
- Investigating enlarged mediastinal lymph nodes of unknown cause
- Diagnosing sarcoidosis, where EBUS has a high yield and has largely replaced surgical biopsy
- Diagnosing tuberculous lymphadenitis, an important use in India, with samples sent for culture and molecular testing
- Sampling lymphoma and metastatic disease from other primary cancers
How EBUS is performed
Preparation is the same as for flexible bronchoscopy: fasting for around six hours, review of blood thinners, and a full medication list.
The procedure is done under sedation, sometimes deeper than standard bronchoscopy because it takes longer. Local anaesthetic numbs the throat, and oxygen, heart rate, blood pressure and oxygen saturation are monitored throughout.
The EBUS scope is passed through the mouth into the trachea. Its ultrasound probe is placed against the airway wall, producing an image of the structures beyond it — lymph nodes, blood vessels and masses. Nodes are identified by station and measured. A fine needle is then passed through the airway wall into the target while the operator watches on ultrasound, so the needle tip is visible at all times and blood vessels are avoided.
Several passes are made from each node, and several node stations are sampled in a defined order so that staging is accurate. Where available, on-site cytology assessment confirms adequate material before the procedure ends.
EBUS usually takes thirty to forty-five minutes.
After EBUS
You are observed until sedation wears off, typically an hour or two, then go home the same day with someone to accompany you. Nothing to eat or drink for about two hours, until the throat anaesthetic has worn off.
A sore throat, hoarseness and slight blood-streaking of sputum for a day are expected. Do not drive for twenty-four hours.
Preliminary cytology is often available within a day or two; full histopathology, cultures and molecular testing take longer. All results are explained together at follow-up, along with what they mean for treatment.
Risks
EBUS is a low-risk procedure in experienced hands. Minor bleeding at the puncture site is the commonest event and almost always settles on its own. Sore throat and hoarseness are usual. Infection or mediastinitis is rare. Pneumothorax is uncommon, as the needle stays within the mediastinum. Sedation-related effects are monitored throughout. Compared with mediastinoscopy, EBUS avoids a surgical incision, general anaesthesia and an inpatient stay.
Occasionally EBUS does not yield a diagnosis and a surgical procedure is still needed. This possibility is discussed beforehand.
Booking EBUS in Rewari
EBUS is arranged after consultation and review of your imaging, so that the nodes to be sampled are planned in advance. Bring all CT and PET-CT films and reports, previous biopsy results, and a list of your medicines.
Having bronchoscopy, EBUS and thoracoscopy available in one place is what shortens the path from suspicion to a staged diagnosis. Book an appointment at Vaayu Care, Rewari.
Frequently asked questions
Why do I need EBUS when the PET-CT already shows abnormal nodes?
PET-CT shows metabolic activity, not tissue. Nodes can light up because of infection, tuberculosis or sarcoidosis rather than cancer, and cancer is sometimes present in nodes that appear normal. Since the presence of cancer in mediastinal nodes decides whether surgery is appropriate, that question has to be answered on a tissue sample rather than an image.
Is EBUS better than surgical mediastinoscopy?
For most staging questions, yes. EBUS reaches more node stations, is done through the natural airway under sedation as a day case, and avoids a neck incision and general anaesthesia. Mediastinoscopy is still used where EBUS cannot reach a particular node or where EBUS results do not fit the clinical picture.
How long does EBUS take and is it painful?
It usually takes thirty to forty-five minutes. It is not painful — the throat is numbed and sedation is given through a vein, so most patients recall very little. You may feel pressure and some urge to cough. You go home the same day, but must not drive for twenty-four hours.
Can EBUS diagnose tuberculosis and sarcoidosis?
Yes, and both are important uses. In sarcoidosis EBUS has a high diagnostic yield and has largely replaced surgical biopsy. In tuberculous lymphadenitis, samples are sent for culture and rapid molecular testing, which also detects drug resistance. In India these are frequent reasons for enlarged mediastinal nodes and must be distinguished from cancer.
What if EBUS does not give an answer?
In a minority of cases the sample is inadequate or inconclusive. Depending on the clinical picture the options are repeating the procedure, proceeding to mediastinoscopy or surgical biopsy, or in some situations following up with imaging. This possibility is explained before the procedure so the plan is clear either way.
How much does an EBUS test cost in Rewari?
EBUS costs more than a plain bronchoscopy because it uses an ultrasound scope and dedicated needles, and the samples go for laboratory and, where needed, molecular testing. The full amount — procedure plus laboratory — is explained after the consultation, before the date is fixed. Call 8563816000 to ask.
How long does EBUS take and will I be admitted?
The procedure itself usually takes thirty to sixty minutes, with an hour or two of observation afterwards. It is a day-case: you go home the same day, with someone to accompany you because of the sedation.