{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T12:12:32Z","timestamp":1778069552518,"version":"3.51.4"},"reference-count":22,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T00:00:00Z","timestamp":1775088000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Laparoendoscopic &amp; Advanced Surgical Techniques"],"published-print":{"date-parts":[[2026,6,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Thoracic esophageal perforation (EP) is a life-threatening emergency. While minimally invasive techniques have been successfully utilized, the heterogeneity of clinical presentations (perforation location, delays in treatment, tissue quality, etc.) has prevented the establishment of a standardized management approach. We present our experience with a minimally invasive management protocol combining thoracoscopy and endoscopy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Between December 2023 and January 2025, 5 patients with thoracic EP underwent a thoracoscopic approach. Primary closure via direct suturing, lavage, and drainage was performed when feasible. Persistent leaks were addressed with endoscopic interventions, including vacuum-assisted therapy and stent placement. A retrospective review of patient medical records was conducted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Of the five perforations, four were right-sided, and one was left-sided. Three cases were spontaneous, while two were iatrogenic (one following bariatric surgery and the other after endoscopic dilation). One patient had a perforation associated with malignancy, and another was on long-term high-dose steroid therapy. Management was initiated within 24 hours after the onset of symptoms in 3 patients and after 48 hours in 2 patients. Persistent leaks occurred in 3 patients (two late presentations and one corticosteroid impregnation). There were no fatalities. Esophageal preservation was achieved in all cases, and all patients resumed oral intake by the end of follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Thoracic EP can be effectively managed using minimally invasive techniques. Avoiding thoracotomy and complex surgical procedures may offer significant benefits for critically ill patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10926429261437684","type":"journal-article","created":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T05:52:11Z","timestamp":1775195531000},"page":"463-469","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Hybrid Minimally Invasive Management of Thoracic Esophageal Perforations: Technical Feasibility in Selected Patients"],"prefix":"10.1177","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8679-6657","authenticated-orcid":false,"given":"Quentin","family":"Chenevas-Paule","sequence":"first","affiliation":[{"name":"Department of Digestive and Emergency Surgery, the University Hospital of Grenoble, University Grenoble Alpes, Grenoble, France."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emmanuel","family":"Devant","sequence":"additional","affiliation":[{"name":"Department of Digestive and Emergency Surgery, the University Hospital of Grenoble, University Grenoble Alpes, Grenoble, France."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierre Yves","family":"Sage","sequence":"additional","affiliation":[{"name":"Department of Digestive and Emergency Surgery, the University Hospital of Grenoble, University Grenoble Alpes, Grenoble, France."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julio","family":"Abba","sequence":"additional","affiliation":[{"name":"Department of Digestive and Emergency Surgery, the University Hospital of Grenoble, University Grenoble Alpes, Grenoble, France."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edouard","family":"Girard","sequence":"additional","affiliation":[{"name":"Department of Digestive and Emergency Surgery, the University Hospital of Grenoble, University Grenoble Alpes, Grenoble, France."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mircea","family":"Chirica","sequence":"additional","affiliation":[{"name":"Department of Digestive and Emergency Surgery, the University Hospital of Grenoble, University Grenoble Alpes, Grenoble, France."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,4,2]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/dote\/dox013"},{"key":"e_1_3_2_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-013-1951-7"},{"key":"e_1_3_2_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2015.304"},{"key":"e_1_3_2_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.6055"},{"key":"e_1_3_2_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.6294"},{"issue":"3","key":"e_1_3_2_7_1","first-page":"1","article-title":"Management and outcome of esophageal stenting for spontaneous esophageal perforations","volume":"30","author":"Glatz T","year":"2017","unstructured":"6.Glatz T, , Marjanovic G, , Kulemann B, et al. 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