UPPER IATROGENIC ESOPHAGEAL PERFORATION SUCCESSFULLY TREATED BY THE “COVER” TECHNIQUE WITH ANCHORING SUTURE: A MINI-INVASIVE SOLUTION IN A “TROUBLESOME” LOCATION

71-year-old woman was referred to our Institute for metachronous neoplastic nodule in the upper-right pulmonary lobe. Following two complex selective orotracheal intubations, the patient underwent complete VATS right upper lobectomy. After 48-hours, patient developed dysphagia. Endoscopy showed a 40-mm longitudinal esophageal laceration 2 cm under the cricoid ring. After the failure of subsequent surgical and endoscopic revisions with clips, FC-SEMS placement with anchoring single-sutures using the OverStitch Endoscopic Suturing System was effectively performed although the too-close location to cricoid ring. After 2 months, stent was removed using a flexiblefully-rotatable endoscopic scissors (Ensizor Flex). At 6-month follow-up, the patient remained asymptomatic.