Pectus less invasive extrapleural repair (PLIER)

Abstract

Purpose of the study: This aim of this study was to evaluate the initial experience of pectus deformity repair using the pectus less invasive extrapleural repair (PLIER) procedure.

Methods: PLIER is an open procedure which involves a small midline chest incision, with exposure of the xiphoid which is raised to create a retrosternal space. The costal cartilages are excised to free the sternum and metal struts are implanted to stabilise the reconstructed chest wall.

Main findings: Corrections were performed on 35 patients [25 pectus excavatum (PE) and 10 pectus carinatum (PC)] with a median age of 15.2 years (range 13-19 years). The mean size of the incision was 7.5 cm (range 7-10.5 cm). The mean operation time was 85 min (75-115 min). There were no intraoperative complications. The follow-up period ranged from 6 months to 2 years.

Conclusions: The initial experience with the PLIER procedure demonstrates that it is suitable for the correction of PE and PC. The advantage of PLIER procedure is that it can be performed through small incisions in a short time with minimal loss of blood. Excellent aesthetic results after the procedure indicate the need to offer this method of surgical correction to low risk children.