Intestinal Anastomosis by Use of a Memory-shaped Compression Anastomosis Clip (Hand CAC 30): Early Clinical Experience.

PURPOSE: The safety and the efficacy of the compression anastomosis clip (Hand CAC 30) have been demonstrated by animal studies. This study was designed to evaluate the clinical validity of the Hand CAC 30 in enterocolic side-to-side anastomosis after colonic or enteric resections. METHODS: A non-randomized prospective data collection was performed for patients undergoing a side-to-side anastomosis using the Hand CAC 30. Eligibility criteria for the use of the Hand CAC 30 were for anastomoses between the colon and the ileum or between two small bowels. The primary short-term endpoint was the rate of anastomotic leakage. Other clinical outcomes, including intra- and postoperative complications, length of operation time and hospital stay, and the clip elimination time were recorded. RESULTS: A total of 63 patients (male, 36) underwent an enteric or right-sided colonic resection followed by a side-to-side anastomosis using the Hand CAC 30. Laparoscopic surgery was performed in 36 patients, in whom one patient who underwent a laparoscopic right hemicolectomy was converted to an open procedure (1/32, 3.1%). One patient with ascending colon cancer showed postoperative anastomotic leakage and died of co-morbid ischemic heart disease. There were no other surgical mortalities. The exact date of expulsion of the clip could not be recorded because most patients were not aware of clip elimination. No patients manifested clinical symptoms of anastomotic stricture. CONCLUSION: Short-term evaluation of the Hand CAC 30 anastomosis in patients undergoing enterocolic surgery proved it to be a safe and efficacious alternative to the standard hand-sewn or stapling technique.

Analyses of calcium carbonate scale deposition on four RO membranes under a seawater desalination condition.

Inorganic fouling is one of the critical operational issues in reverse osmosis membrane. Few researches investigated effects of membrane surface characteristics on inorganic fouling and on anti-scaling techniques although the fouling occurs on the membrane surface. The objective of this paper was to examine whether different characteristics of deposition of calcium carbonate solids would occur on four membranes having distinctive surface properties. A lab-scale cell reactor with a crossflow velocity was installed and two coupons were used for one type of membranes. Two feed waters were examined: concentrated synthetic seawater simulating a 30% recovery and a concentrate from a seawater RO plant in operation at Changwon, Korea. The amounts of solid deposition on the attached membranes were increased in all four membranes but the degree of deposition on each membrane was different. Various types of calcium carbonate solids were clearly detected by both XRD and SEM analyses. In general, a membrane with greater roughness and negative surface charge appeared to form more scales. This implied that membrane surface characteristics such as roughness and surface charge affected inorganic fouling, presumably by providing favourable sites for precipitation and enhancing attraction of species to the membrane surface.