The authors describe an original technique of excision in severe caustic burns of the upper digestive tract: oesophagectomy without thoracotomy. The new procedure avoids the wide pleural opening of the thoracic approach, which leads to frequent and often fatal respiratory and infectious complications, whereas extrapleural drainage of the mediastinum has always proved effective and safe. Five technically successful operations were performed in one year. One patient died on the 10th post-operative day of tracheal necrosis related of the burn and 4 patients survived. These preliminary results are encouraging.