To the editor:Conjoined twinning is a rare congenital malformation,which occurs in single chorionic amniotic twins.Most of the twins are dead in embryomc period;thus it is uncommon to surgically separate the conjoined twins successfully and for both to survive.1 It is necessary to improve the perioperative management and increase the survival rate of the separation of thoraco-omphalopagus symmetrically conjoined twins.