L Spitz1, E M Kiely. 1. Department of Paediatric Surgery, Great Ormond Street Hospital for Children, London, UK. L.Spitz@ich.acl.ac.uk
Abstract
BACKGROUND: Conjoined twins occur in approximately one in 200 000 live births. Their management is often extremely complex and experience with large numbers is restricted to a few centres worldwide. METHODS: An analysis of 17 sets of symmetrical conjoined twins managed by a single team of surgeons over a 16-year period was undertaken. RESULTS: Management could be divided into three groups. Those in group 1 (n = 5) had non-operative management, owing to cardiac fusion or gross anatomical union, and all died. Those in group 2 (n = 7) underwent emergency separation, when one twin was dead or threatening the survival of the sibling or where there was a correctable life-threatening associated anomaly (four of 14 survived). Twins in group 3 (n = 5) underwent elective separation, allowing time for detailed preoperative investigation and planning (eight of ten survived). CONCLUSION: Accurate preoperative investigation, a team approach, previous experience, and meticulous operative and postoperative management contributed to the success rate achieved in this series.
BACKGROUND: Conjoined twins occur in approximately one in 200 000 live births. Their management is often extremely complex and experience with large numbers is restricted to a few centres worldwide. METHODS: An analysis of 17 sets of symmetrical conjoined twins managed by a single team of surgeons over a 16-year period was undertaken. RESULTS: Management could be divided into three groups. Those in group 1 (n = 5) had non-operative management, owing to cardiac fusion or gross anatomical union, and all died. Those in group 2 (n = 7) underwent emergency separation, when one twin was dead or threatening the survival of the sibling or where there was a correctable life-threatening associated anomaly (four of 14 survived). Twins in group 3 (n = 5) underwent elective separation, allowing time for detailed preoperative investigation and planning (eight of ten survived). CONCLUSION: Accurate preoperative investigation, a team approach, previous experience, and meticulous operative and postoperative management contributed to the success rate achieved in this series.
Authors: Osvaldo M Mutchinick; Leonora Luna-Muñoz; Emmanuelle Amar; Marian K Bakker; Maurizio Clementi; Guido Cocchi; Maria da Graça Dutra; Marcia L Feldkamp; Danielle Landau; Emanuele Leoncini; Zhu Li; Brian Lowry; Lisa K Marengo; María-Luisa Martínez-Frías; Pierpaolo Mastroiacovo; Julia Métneki; Margery Morgan; Anna Pierini; Anke Rissman; Annukka Ritvanen; Gioacchino Scarano; Csaba Siffel; Elena Szabova; Jazmín Arteaga-Vázquez Journal: Am J Med Genet C Semin Med Genet Date: 2011-10-14 Impact factor: 3.908
Authors: R E Andrews; C J McMahon; R W M Yates; S Cullen; M R de Leval; E M Kiely; L Spitz; I D Sullivan Journal: Heart Date: 2005-08-23 Impact factor: 5.994