Perforations of the thoracic esophagus can be fatal unless diagnosed promptly and treated effectively. Two patients in whom primary repair was not feasible were treated by esophageal exclusion and diversion using nonabsorbable stapling devices. Both patients had spontaneous recanalization of the esophagus without leakage or stricture formation. We conclude that nonabsorbable staples can be used safely to achieve effective esophageal exclusion, thereby allowing complete healing of the perforation. Furthermore, use of this technique may eliminate the necessity for another major procedure to reestablish esophageal continuity.