Doctors Voice Optimism for Twins (2002)

Dr. Jorge Lazareff, director of the UCLA Pediatric Neurosurgery Program and lead neurosurgeon, smiles at a news conference, Tuesday, Aug. 6, 2002One-year-old Guatemalan twins joined at the head were separated in a marathon operation that ended early Tuesday, but one sister was returned to surgery a few hours later because of bleeding on her brain.

Maria Teresa Quiej Alvarez and her sister, Maria de Jesus, were in critical but stable condition Tuesday night at the University of California at Los Angeles Medical Center, but doctors were optimistic about their recovery. They were expected to remain sedated and using breathing tubes for days.

"I'm absolutely positive they will do OK. I'm absolutely positive if you go and visit them in five years they will be leading a normal life," said Dr. Jorge Lazareff, the lead neurosurgeon.

The doctors' sense was that the girls fared well, but it remained to be determined whether they suffered any brain damage, said Dr. John Frazee, another neurosurgeon.

"They're moving, which is a good sign. There's no way of knowing what the state of affairs is for another week," Frazee said.

After the 22-hour risky separation surgery, Maria Teresa was wheeled back into the operating room for nearly five more hours because of a buildup of blood on her brain, Lazareff said.

The girls were born attached at the top of the skull and faced opposite directions. While the two shared bone and blood vessels, they had separate brains. Cases like theirs occur in fewer than one in 2.5 million live births.

In the riskiest part of the surgery, doctors had to separate blood vessels the two girls shared and decide which belonged to each child. That was followed by plastic surgery to extend each girl's scalp to cover the area where they had been attached.

The two face still more operations to reconstruct their skulls.

Surgeons around the world have performed cranial separations only five other times in the past decade, and not all twins have survived.

一对仅一岁的危地马拉连脑女婴在经历了一场马拉松式的手术之后，终于被分开了。手术于8月6日早上结束，但不幸的是仅仅在几小时之后，其中一名女婴因头部出血而被再次送回手术室。

手术后当晚，这对连体姐妹玛利亚·特蕾莎·阿尔瓦雷斯和玛利亚·赫苏斯留在加利福尼亚洛杉矶医学中心接受观察，她们还没有脱离危险但情况还算稳定。不过医生对她们的康复是充满信心的。在接下来的一段时间里，这对姐妹仍需要依靠镇定剂和氧气管维持生命。

主治医生神经外科医生拉扎雷夫博士说："我对她们的康复感到非常乐观。我敢保证，如果你5年后再去看望这对姐妹，会看到她们已经过上了正常人的生活。"

而另一位神经外科医生约翰·弗雷齐博士却认为，虽然目前这对姐妹的情况很好，但还不能确保她们的脑部没有受到损伤。

弗雷齐说："她们能够活动，这是一个很好的迹象。但在一个星期内还无法确定她们的情况究竟如何"。

拉扎雷夫说，在长达22小时的险象环生分离手术后，玛利亚·特蕾沙由于脑部积血而被推回了手术室，手术又继续了将近5小时之久。

两姐妹生下来头骨就相连，而脸则朝向相反的方向。她们共用骨骼和血管，但大脑却是各自独立的。这种情况出现的几率不到250万分之一。

该手术最危险的部分在于，医生必须分离两姐妹共享的血管并判断哪一部分该属于谁。医生在完成分离手术后还要对她们进行外科整形，使每个女婴的头皮都能覆盖她们被分离的部位。

接下来两姐妹还将接受一系列修复头骨的手术。

除了这次手术之外，在过去十年中，全世界仅实行了五例类似的头部分离外科手术，但并不是所有的双胞胎都能够存活下来。