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Elevation of iliocostalis lumborum muscle flap based on T10 and T11 intercostal perforators. Ribs 9–11 are segmentally resected, and T10–11 intercostal vessels are divided laterally (*). Esophageal stent through the defect (arrow) is visible and numerous sutures are placed around the defect for parachuting the flap. The blue area (arrowhead) outlines the area that will seal the esophageal defect once rotated into intrathoracic space.
