[Combined cervical and thoracic approach to the removal of tumours responsible for the Pancoast and Tobias syndrome (author's transl)].

The authors review the various treatments of the Pancoast and Tobias syndrome and propose a new surgical approach in two stages. The first, cervical stage involves resection of the internal half of the clavicle and of the first rib and dissection of the vessels and nerves lying in the supraclavicular fossa, so that the tumour can be lowered in one piece and exposed. The second stage consists of posterolateral thoracotomy with exeresis of the lung. The wide cervicotomy has several advantages: the tumour can be biopsied for extemporaneous histological examination, and its extension to the lymph nodes, thoracic wall and mediastinum can be assessed; freeing the nerves relieves pain and considerably facilitates the second stage of the operation.