Rahayatri Tri Hening, Amaliah Rizky, Putri Nandita Melati, Puspaningtyas Niken Wahyu, Karyanti Mulya Rahma, Hendarto Aryono
Faculty of Medicine, Universitas Indonesia, Pediatric Surgery Division, Department of Surgery, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Faculty of Medicine, Universitas Indonesia, Pediatric Surgery Division, Department of Surgery, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Int J Surg Case Rep. 2021 Jul;84:106150. doi: 10.1016/j.ijscr.2021.106150. Epub 2021 Jun 29.
Conjoined twin is a rare congenital anomaly characterized by a fusion of certain anatomical structures. Coronavirus-19 (COVID-19) is a new emerging infectious respiratory disease affecting worldwide and potentially leads to acute respiratory distress (ARDS) in children. COVID-19 has reconstructed the healthcare system, including surgical care and decision-making.
Herein we describe a surgical separation of 2.5 months old omphalopagus conjoined twins, with one of them (Baby A) presenting COVID-19-associated respiratory distress, as well as the challenges faced during the preparation and the execution of the complex surgical procedure.
Baby A underwent antiviral therapy, oxygen supplementation, and ventilation in the ICU, while baby B remained stable and confirmed negative for SARS-CoV-2. The separation surgery was conducted after baby A had become clinically stable. Defect closure and reconstruction were accomplished. At one week follow-up, Baby A died of lung infection, while baby B remained well after one year.
The complexity of surgical separation requires careful planning by a multidisciplinary team. Surgical separation of conjoined twins during the pandemic era has not been reported much in the literature, more reports are required to provide further insight.
联体双胎是一种罕见的先天性异常，其特征为某些解剖结构融合。冠状病毒病-19（COVID-19）是一种新出现的传染性呼吸道疾病，在全球范围内造成影响，并可能导致儿童急性呼吸窘迫（ARDS）。COVID-19重塑了医疗保健系统，包括外科护理和决策制定。
在此，我们描述了一对2.5个月大的胸腹联体双胎的手术分离情况，其中之一（婴儿A）出现了与COVID-19相关的呼吸窘迫，以及在准备和实施复杂手术过程中所面临的挑战。
婴儿A在重症监护病房接受了抗病毒治疗、吸氧和通气，而婴儿B保持稳定，且严重急性呼吸综合征冠状病毒2（SARS-CoV-2）检测呈阴性。在婴儿A临床稳定后进行了分离手术。完成了缺损闭合和重建。在术后一周的随访中，婴儿A死于肺部感染，而婴儿B在一年后情况良好。
手术分离的复杂性需要多学科团队进行仔细规划。在大流行时代联体双胎的手术分离在文献中报道不多，需要更多报告以提供进一步见解。
