TY - JOUR ID - 46359 TI - Successful Surgical Separation of Thoraco-Omphalopagus Symmetrical Conjoined Twins in Iran: Two Case Reports JO - Iranian Journal of Medical Sciences JA - IJMS LA - en SN - 0253-0716 AU - Bahador, Ali AU - Nikeghbalain, Saman AU - Foroughi, Mehdi AU - Beizavi, Zahra AU - Sahmeddini, Mohammad Ali AU - Eghbal, Mohammad Hossein AU - Vafaei, Homeira AU - Malekhosseini, Seyyed Ali AU - Bahador, Mohsen AD - Department of Pediatric Surgery, Namazee Hospital, Shiraz University of Medical Science, Shiraz, Iran AD - Shiraz Transplant Medical Center, Namazee Hospital, Shiraz University of Medical Science, Shiraz, Iran AD - General Surgery Resident, Department of General Surgery, Shiraz University of Medical Science, Shiraz, Iran AD - Shiraz Anesthesiology and Clinical Care Research Center, Shiraz University of Medical Science, Shiraz, Iran AD - Maternal Fetal Medicine Research Center, Perinatology Ward, Shiraz University of Medical Science, Shiraz, Iran AD - Student Research Committee, Department of Otorhinolaryngology, Shiraz University of Medical Science, Shiraz, Iran Y1 - 2020 PY - 2020 VL - 45 IS - 2 SP - 143 EP - 147 KW - Twins, conjoined KW - Congenital abnormalities KW - Reconstructive Surgical Procedures DO - 10.30476/ijms.2019.81060. N2 - Conjoined twins are derived from the division of a single fertilized ovum; a phenomenon accompanied with multiple congenital anomalies. Such twins are identical, of the same sex, and more likely to be female. Most twins die during the embryonic period, and only 18% survive longer than 24 hours. There are complex anomalies in thoraco-omphalopagus twins that makes them unlikely to live long enough to undergo separation. Treatment of this uncommon condition presents both surgical and anesthetic challenges. The management of rare anomalies is difficult even for skilled surgeons. Therefore, it is logical to use the knowledge gained from previous experiences. We herein present the first successful surgical separation of two pairs of thoraco-omphalopagus conjoined twins at the Pediatric Surgery Center of Namazi Hospital (Shiraz, Iran). In both cases, the neonates had separate hearts and common pericardium. Contrast-enhanced computed tomography of two sets of twins showed fusion of sternum, pericardium, diaphragm, and left lobe of liver. Critical steps of the surgical separation were identified and contingency plans were made for possible partial liver donation and cross-circulation between twins. The separation procedure and reconstruction of the abdominal wall were successfully performed. Both pairs of twins, now 6- and 8-year-old, are healthy and have normal growth and are under follow-up. UR - https://ijms.sums.ac.ir/article_46359.html L1 - https://ijms.sums.ac.ir/article_46359_5e88161554af01db3e237c9b4dea8bf0.pdf ER -