Anesthesia and perioperative challenges for surgical separation of thoraco-omphalopagus twins: case report

Freitas, Milton Halyson Benevides de; Lima, Luciana Cavalcanti; Couceiro, Tânia Cursino de Menezes; Costa, Maria Célia Ferreira da; Freitas, Marcio Handerson Benevides de

doi:10.1016/j.bjane.2018.10.004

Cited by 1 publication

(2 citation statements)

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“…[ 1 47 48 49 ] However, many authors used the term thoraco-omphalopagus to describe the twins which are fused from the thorax to the upper abdomen. [ 10 11 12 13 21 22 23 25 24 25 26 27 ] The thoraco-omphalopagus twins account for 70% of conjoined twins and are associated with the highest mortality rates of 51% due to complex cardiac anomalies. [ 5 10 13 ]…”

Section: Discussionmentioning

confidence: 99%

“…Including our patients, we found data of 158 thoracopagus and thoraco-omphalopagus sets in 7 case series,[ 1 2 3 4 5 6 7 ] 2 review articles,[ 8 9 ] and 36 case reports. [ 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 ] The age at surgery was mentioned for 63 sets ranging from 11 h–144 months, with a median age of 2.75 months (IQR = 5.5). Sex was documented in 77 sets with 23 males and 54 females (M: F = 1:2.3).…”

Section: R Esultsmentioning

confidence: 99%

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Conjoined Thoracopagus Twins: A Systematic Review of the Anomalies and Outcome of Surgical Separation

Saxena

Sinha

Pathak

et al. 2023

African Journal of Paediatric Surgery

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Introduction: Conjoined twin is an extremely rare condition and requires a thorough knowledge of anatomy, and a multidisciplinary approach is essential to successfully separate the twins. Thoracopagus twins lie face to face and are attached from chest to upper abdomen. They are the most common among all the varieties but have a poor survival rate. Materials and Methods: This study is a review of literature from 2019 to the oldest via PubMed and Google Scholar using keywords: Conjoined twins, Thoracopagus twins, Thoracoomphalopagus and Thoraco-omphalopagus twins. The articles were reviewed for the description of the anatomy of shared organs, management and outcome of these twins. Results: One hundred and fifty-eight sets of thoracopagus and thoraco-omphalopagus twins including our twins were included in this study. Out of 158 reported thoracopagus twin sets in literature, with M: F ratio of 1:2.3, 71 sets were found to be non-operable and all of them subsequently expired; 82 sets were operated upon, out of which 83 babies survived, suggesting an overall surgical success rate of about 50%. Conclusion: Thoracopagus twins have a dismal prognosis. The most important decisive parameter for successful separation is the extent of sharing of organs between twins. The role of a motivated multidisciplinary team is also indispensable and cannot be overemphasised.

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