[Separation of gastrothoracopagus conjoined twins: 2 cases report]. 2007

Jia-ming Sun, and Qing-lan Ruan, and Zong-quan Sun, and Shao-tao Tang, and Yi-ming Zhang, and Rui Zeng
Department of Plastic Surgery, Union Hospital, Huazhong University of Science & Technology, Wuhan 430022, China. sunjm1592@sina.com

OBJECTIVE To investigate reasonable surgical therapy for conjoined twins. METHODS Two pairs of gastrothoracopagus were admitted in July 2004 and April 2005 respectively. The first pair was separated by emergency surgery for the rupture of umbilical hernia resulting in the exposure of intestines. The thoracic and abdominal wall was repaired with local skin flaps, and the secondary wound was covered with artificial skin. Skin expanders were embedded in thoracic and abdominal wall 2 months after birth in the second pair. The surgical separation was performed one month after. The deficiencies of pericardium, sternum and abdominal wall were reconstructed by allogenic grafting of pericardium, porous polyethylene implant and monofilament polypropylene patch respectively. The thoracic and abdominal wall was repaired with expanded rotation skin flap. RESULTS The first twins died of respiratory failure and circulatory and respiratory failure 2 hours and 39 hours after the separation respectively. Both of the second pair survived and were discharge after healing. CONCLUSIONS The separation of gastrothoracopagus should be performed after skin expansion in the interest of the closure of wound. It's better to use porous polyethylene implant and monofilament polypropylene patch to reconstruct the sternum and abdominal wall respectively.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D014428 Twins, Conjoined MONOZYGOTIC TWINS who are joined in utero. They may be well developed and share only a superficial connection, often in the frontal, transverse or sagittal body plane, or they may share a partial duplication of a body structure. Alternatively, there may be a small and incompletely developed twin conjoined to a larger, more fully developed twin. Siamese Twins,Twins, Siamese,Conjoined Twin,Conjoined Twins,Siamese Twin,Twin, Conjoined,Twin, Siamese
D017809 Fatal Outcome Death resulting from the presence of a disease in an individual, as shown by a single case report or a limited number of patients. This should be differentiated from DEATH, the physiological cessation of life and from MORTALITY, an epidemiological or statistical concept. Fatal Outcomes,Outcome, Fatal,Outcomes, Fatal
D019651 Plastic Surgery Procedures Procedures used to reconstruct, restore, or improve defective, damaged, or missing structures. Cosmetic Reconstructive Surgical Procedures,Cosmetic Surgical Procedures,Esthetic Reconstructive Surgical Procedures,Esthetic Surgical Procedures,Plastic Surgical Procedures,Reconstructive Surgical Procedures,Reconstructive Surgical Procedures, Cosmetic,Cosmetic Reconstructive Surgery,Procedure, Reconstructive Surgical,Procedures, Reconstructive Surgical,Reconstructive Surgical Procedure,Reconstructive Surgical Procedures, Esthetic,Surgical Procedure, Reconstructive,Surgical Procedures, Reconstructive,Cosmetic Reconstructive Surgeries,Cosmetic Surgical Procedure,Esthetic Surgical Procedure,Plastic Surgery Procedure,Plastic Surgical Procedure,Procedure, Cosmetic Surgical,Procedure, Esthetic Surgical,Procedure, Plastic Surgery,Procedure, Plastic Surgical,Procedures, Cosmetic Surgical,Procedures, Esthetic Surgical,Procedures, Plastic Surgery,Procedures, Plastic Surgical,Reconstructive Surgeries, Cosmetic,Reconstructive Surgery, Cosmetic,Surgeries, Cosmetic Reconstructive,Surgery Procedure, Plastic,Surgery Procedures, Plastic,Surgery, Cosmetic Reconstructive,Surgical Procedure, Cosmetic,Surgical Procedure, Esthetic,Surgical Procedure, Plastic,Surgical Procedures, Cosmetic,Surgical Procedures, Esthetic,Surgical Procedures, Plastic
D034861 Abdominal Wall The outer margins of the ABDOMEN, extending from the osteocartilaginous thoracic cage to the PELVIS. Though its major part is muscular, the abdominal wall consists of at least seven layers: the SKIN, subcutaneous fat, deep FASCIA; ABDOMINAL MUSCLES, transversalis fascia, extraperitoneal fat, and the parietal PERITONEUM. Wall, Abdominal
D035441 Thoracic Wall The outer margins of the thorax containing SKIN, deep FASCIA; THORACIC VERTEBRAE; RIBS; STERNUM; and MUSCLES. Chest Wall,Wall, Chest,Wall, Thoracic

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