Gains from the separation of two cases of conjoined twins

Summary 

Background

Conjoined twins are rare congenital malformations. Those who were successfully separated with both twins surviving are even more rare.

Method

Two pairs of gastrothoracopagus were admitted to our hospital. The first pair was separated by emergency surgery following the rupture of an umbilical hernia. The wound was repaired by local skin flaps grafting and artificial skin. For the second pair, skin expanders were embedded in the thoracic and abdominal wall, the separation was performed 1 month later, the defects were reconstructed by allogenic pericardium, porous high-density polyethylene implant (Medpor) monofilament polypropylene patch and expanded rotation flap.

Result

The first twins, died of respiratory failure and circulatory and respiratory failure 2h and 39h, respectively, after the separation, while both of the second pair survived and were discharged after healing.

Conclusion

If the general status is allowed, the separation of gastrothoracopagus should be performed after skin expansion, it is better to use Medpor to reconstruct the sternum, and the best time to perform the separation is 3 months after birth.

Keywords: Conjoined twins, Gastrothoracopagus, Preoperative assessment, Defect repairing, Skin expander