Echo-endoscopic lymph node staging in lung cancer: an endoscopic alternative.

Surgical staging by mediastinoscopy has been considered the gold standard for staging the mediastinum in non-small-cell lung cancer; however, it is an invasive procedure which requires general anesthesia and is associated with significant risk. Endosonographic biopsy techniques are a minimally invasive alternative to surgical staging and may be even better than standard mediastinoscopy. Combined endosonographic procedures (EBUS/EUS) are safe, cost-effective, and superior to surgical mediastinal staging. It allows for the biopsy of lymph nodes and metastases that are unattainable with standard mediastinoscopy techniques thereby preventing futile thoracotomies. Combined endosonographic procedures (EBUS/EUS) are the new gold standard in mediastinal staging of non-small-cell lung cancer when performed by an experienced operator.