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Point/Counterpoint Editorials |

Rebuttal From Drs Wahidi and ErnstRebuttal From Drs Wahidi and Ernst

Momen M. Wahidi, MD, MBA, FCCP; Armin Ernst, MD, MHCM, FCCP
Author and Funding Information

From the Division of Pulmonary and Critical Care Medicine (Dr Wahidi) and Department of Medicine, Duke University Medical Center; and Reliant Medical Group (Dr Ernst).

Correspondence to: Momen M. Wahidi, MD, MBA, FCCP, Division of Pulmonary and Critical Care Medicine, Duke University Medical Center, Box 3683, Durham, NC 27710; e-mail: momen.wahidi@duke.edu


Financial/nonfinancial disclosures: The authors have reported to CHEST the following conflicts of interest: Dr Wahidi has served as a consultant with Olympus Corp and received educational grants from Olympus Corp and Pentax of America Inc. Dr Ernst has reported that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2014;145(3):451-452. doi:10.1378/chest.13-2723
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Medical myths die hard! Drs Farjah and Wood1 point out deficiencies in the ultrasonographic approach that have been disproved by data or overcome by innovative solutions. These include a lack of effectiveness in sampling the radiographically normal mediastinum, an inability of endobronchial ultrasound (EBUS) and esophageal ultrasound (EUS) to collect adequate tissue for molecular analysis, and logistical difficulty in performing EBUS and EUS simultaneously. On the other hand, the authors claim an excellent track record of surgical staging in lung cancer. A survey in 2005 gathered information on the surgical care of the patient with lung cancer and illustrated the poor state of affairs in the United States: Only 27% of surgical patients underwent mediastinoscopy, and only 46% of those undergoing the procedure had documented evidence of lymph node biopsy material submitted to pathology.2 This is one of the reasons why new approaches and opportunities for staging access are desperately needed to provide patients with the best possible care.

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