[Separation of gastrothoracopagus conjoined twins: 2 cases report].
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.
Sun
Jia-ming
JM
Department of Plastic Surgery, Union Hospital, Huazhong University of Science & Technology, Wuhan 430022, China. sunjm1592@sina.com
Ruan
Qing-lan
QL
Sun
Zong-quan
ZQ
Tang
Shao-tao
ST
Zhang
Yi-ming
YM
Zeng
Rui
R
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*