Monday, April 20, 2009

Reconsider plans: Khaw

April 19, 2009

By Judith Tan

THREE of the four twins joined at the head who were separated in operations here are dead, and the fourth is not in good shape.

Given this track record and the similarly dismal results overseas, Health Minister Khaw Boon Wan on Sunday suggested that doctors reconsider plans to separate yet another pair of such conjoined twins.

Indian twins Vani and Veena, five, will go under the knife at East Shore Hospital in August, if the medical team involved decides to proceed with the operation.

Neurosurgeon Keith Goh, who was involved in the marathon surgeries here to separate the two earlier sets of twins joined at the head, has been asked by the state government of Andhra Pradesh in India to carry out the surgery.

Speaking to reporters on Sunday at a grassroots event, Mr Khaw said that doctors would likely end up harming the patients, and should not attempt such operations.

'Surgeons, in some instances, have to pick one twin to die to save the other. Even those who survived would often be left with brain damage. So, to what extent is this quality of life?'

International studies have shown the chances of surviving surgery for 40 pairs of twins joined at the head was rated 50:50 - one twin would not survive the operation.

And the Health Minister said the outcome of the two operations here 'reaffirmed these awful statistics'.

In 2001, a team from the Singapore General Hospital separated 11-month-old Nepali conjoined twins Ganga and Jamuna.

Ganga, the weaker twin, died at age eight from a severe chest infection while Jamuna, the surviving twin, had numerous complications, including a potentially-fatal problem with her spinal cord.

[Dr Lee Wei Ling made a slightly different point - that such surgery serves at best to prolong life without improving quality of life. Now it would seem that it does not even have that great a chance of prolonging life, let alone improving quality of life.]

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