Novel hybrid approaches for superior sulcus tumors

Superior sulcus tumors of the lung, while relatively rare, represent a unique and complex challenge in thoracic surgery. As they are often locally advanced at the time of diagnosis, surgical resection, when feasible, is often complex and multidisciplinary in nature and carries significant complication risks for the patient. We present two cases of superior sulcus tumors successfully resected following neoadjuvant chemoradiotherapy using a hybrid, video-assisted thoracoscopic surgery (VATS)-assisted, posterior, limited access incisional technique that will be described in detail. With appropriate patient selection and careful preoperative planning, this is a safe and feasible approach to locally advanced superior sulcus tumors of the lung.