title: [Separation of gastrothoracopagus conjoined twins: 2 cases report].
abstract: 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.
authors: Department of Plastic Surgery, Union Hospital, Huazhong University of Science & Technology, Wuhan 430022, China. sunjm1592@sina.com
authors: Jia-ming
authors: JM
authors: Sun
authors: Qing-lan
authors: QL
authors: Ruan
authors: Zong-quan
authors: ZQ
authors: Sun
authors: Shao-tao
authors: ST
authors: Tang
authors: Yi-ming
authors: YM
authors: Zhang
authors: Rui
authors: R
authors: Zeng
mesh_terms: D034861:Abdominal Wall / Q000002:abnormalities / Q000601:surgery*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019651:Plastic Surgery Procedures; D035441:Thoracic Wall / Q000002:abnormalities / Q000601:surgery*; D014428:Twins, Conjoined / Q000601:surgery*