[Separation of thoracopagus conjoined twins]

To sam up the experience in diagnosis and separation of a thoracopagus conjoined twins.

Thoracopagus twin boys were admitted for evaluating possible separation and repair at age of 21 days. X-rays, CT, MRI, and ultrasound scan of torso showed separate and normal gastrointestinal and biliary tracts, little shared vasculature, but shared pericardium, diaphragm and liver parenchyma. The chest junctions were at the sternums and the most inferior two pairs of the ribs. One twin (twin A) had a protruding heart with VSD and ASD.

The infants were separated successfully at age of 45 days. The chest defect of twin A was closed with aid of a polyester pericardial patch graft and a silicon supporter. Managing anesthesia met some difficulty in understanding of the anatomical and physiological consequences of the complex anomaly. They are had brain edema and multiple system organ failures after separation, and were cured under intensive care. They are alive and well 6 months after surgery.

Careful preoperative evaluation proper anesthesia and surgical technique, and postoperative care are essential to the successful separation of the conjoined twins.