Conjoined Twins – Past, Present and Future

Background/Purpose: Conjoined twins are rare and complex anomaliesof the newborn. They require a highly experienced team anda center equipped to deal with such challenging anatomy.Method: A review of thirty-four sets of conjoined twins was managedby one Team over a sixteen year period. The spectrum of theanomalies, management strategies and outcomes will be analyzedwith future recommendations.Results: Eleven sets of complete conjoined twins and two sets ofparasitic conjoined twins were successfully separated. Tissue expandersand prosthetic meshes were not required. A separation ofone set of craniopagus parasiticus conjoined twins was attempted,but abandoned due to major vascular and brain sharing. The remainingtwenty sets were not separable due to major cardiac anomaliesand/or sharing, and all died within several weeks of birth.Conclusion: Careful planning, a multidisciplinary approach, rehearsaland experience are important factors in dealing with conjoinedtwins. Tissue expanders and prosthetic meshes are not required inmost cases. Selective abortion or fetal intervention may play a rolein the future.