Combined thoracic and cardiothoracic surgery to break the surgical barrier Successful removal of complex nerve sheath tumor occupying cervical root, thoracic inlet and posterior mediastinum Recently, Zhang Peng, director of thoracic and cardiothoracic surgery of Tianjin Medical University General Hospital, together with Ma Xinlong, president of Tianjin Hospital, and Luo Yudong, director of vascular surgery of General Hospital, successfully operated on a patient with complex nerve sheath tumor occupying the left cervical root, thoracic inlet and posterior mediastinum. The patient, a middle-aged male, had been seen by many hospitals in China. Due to the large size of the tumor, its special location, the need to involve several large blood vessels and important nerves in the operation, and the possibility of serious limb dysfunction after the operation, no hospital was willing to treat him. After receiving the diagnosis, the Department of Thoracic Surgery of General Hospital, under the efforts of Professor Zhang Peng, the head of the department, contacted multidisciplinary experts, discussed several times to determine the surgical plan, and informed in detail the risks of the operation with the great attention and participation of the hospital leaders in charge. The surgery lasted for more than 4 hours, firstly, Director Zhang Peng performed a transverse neck incision plus a median open chest incision to expose and explore the tumor, and completed the chest freeing. Director Luo Yudong dissected out many large blood vessels and important nerves in front of the tumor to avoid damage, and President Ma Xinlong bypassed these blood vessels and nerves and removed the tumor completely. The patient is now recovering well after surgery without any postoperative complications or limb dysfunction.