Kho Uy Esther, Speranza Mary, Wong Clemencia S
Children’s Hospital at Montefiore, Bronx, NY, USA..
AORN J. 2012 Aug;96(2):125-51. doi: 10.1016/j.aorn.2012.05.012.
During 2003 and 2004, a multidisciplinary team at the Children's Hospital at Montefiore, Bronx, New York, successfully separated twin infants who presented with a total craniopagus vertical O'Connell type 1 conjoining. The twins underwent a series of four staged separation procedures over 10 months. The first three stages involved performing gradual circumferential craniotomies, dividing the dura, ligating large and small bridging veins, separating abutting brains, and inserting skin expanders. The fourth stage involved dividing the remaining dura and veins, transecting shared brain tissue not detected in preoperative imaging, replacing dura in twin B, and replacing skin over native dura in twin A. Planning and carrying out separation of the conjoined twins required organization and cooperation of all the disciplines involved to prepare the children preoperatively, care for them perioperatively and postoperatively, and support the mother during the process.
2003年至2004年期间，纽约布朗克斯区蒙特菲奥里儿童医院的一个多学科团队成功分离了一对患有完全垂直颅联体奥康奈尔1型联体的双胞胎婴儿。这对双胞胎在10个月内接受了一系列四个阶段的分离手术。前三个阶段包括逐步进行环形开颅手术、切开硬脑膜、结扎大小桥静脉、分离相邻的大脑以及插入皮肤扩张器。第四阶段包括切开剩余的硬脑膜和静脉、横断术前影像学检查未发现的共享脑组织、在双胞胎B中替换硬脑膜以及在双胞胎A中替换天然硬脑膜上的皮肤。连体双胞胎的分离计划和实施需要所有相关学科的组织和合作，以便在术前为患儿做好准备，在围手术期和术后照顾他们，并在此过程中支持母亲。
