Hybrid video-assisted and limited open (VALO) resection of superior sulcus tumors

Alon Ben Nun*, David Simansky, Merav Rokah, Nona Zeitlin, Roni Ben Avi, Michalle Soudack, Nir Golan, Sarit Apel, Jair Bar, Alon Yelin

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Purpose: To compare the postoperative recovery of patients with superior sulcus tumors (Pancoast tumors) following conventional open surgery vs. a hybrid video-assisted and limited open approach (VALO). Methods: The subjects of this retrospective study were 20 patients we operated on to resect a Pancoast tumor. All patients received induction chemo-radiation followed by surgery, performed via either a conventional thoracotomy approach (n = 10) or the hybrid VALO approach (n = 10). In the hybrid VALO group, lobectomy and internal chest wall preparation were performed using a video technique, with rib resection and specimen removal through a limited incision. Results: There was no mortality in either group. Two patients from the thoracotomy group required mechanical ventilation, but there was no major morbidity in the hybrid VALO group. The operative times were similar for the two procedures. The average length of hospital stay was shorter and the average pain scores were significantly lower in the hybrid VALO group. The incidence of chronic pain was 10 % in the hybrid VALO group vs. 50 % in the thoracotomy group. Conclusions: Hybrid VALO resection of Pancoast tumors is feasible and safe, resulting in faster patient recovery and a significantly lower incidence of severe chronic pain than open thoracotomy. We conclude that centers experienced with video-assisted lobectomy should consider hybrid VALO surgery as the procedure of choice for Pancoast tumors.

Original languageEnglish
Pages (from-to)686-690
Number of pages5
JournalSurgery Today
Issue number6
StatePublished - 1 Jun 2016


  • Lung cancer
  • Surgical techniques
  • Thoracoscopy/VATS


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