SURGICAL TIMING FOR BLEEDING SIGMOID COLON ADENOCARCINOMA AFTER CORONARY ARTERY BYPASS GRAFT: A DUAL CASE EXPERIENCE AND REVIEW OF LITERATURE IN PAST TWO DECADES The optimal timing of noncardiac surgery (NCS) after coronary artery bypass grafting (CABG) remains inadequately elucidated in current literature. The intricate balance between advantageous oncological outcomes associated with expeditious curative resection and the potential risk of significant post-NCS cardiac events following CABG presents a complex dilemma. This study presents a retrospective analysis of two cases involving bleeding sigmoid adenocarcinoma in the context of concomitant occlusive coronary disease. Both patients underwent CABG followed by early anterior resection. Notably, no major adverse cardiac events were observed following anterior resection procedures, and patients were discharged within a week uneventfully. A comprehensive review of literature spanning two decades was undertaken to contextualize these findings. Apparent scarcity of definitive evidence underscores the necessity for more extensive and conclusive data to establish precise guidelines for the optimal timing of NCS post-CABG.

Purpose: The purpose of this study was to demonstrate the feasibility and safety of laparoscopic-assisted anterior resection (LAAR) for colorectal cancer in a local Asian population. Methods: This is a retrospective review of all patients with colorectal cancer operated from November 2017 to October 2018. Main variables of interest were demography, type and surgery, length of stay (LOS), and the involvement of proximal and distal doughnut. Postoperative complications were analysed using chi-square or Fisher exact and Mann-Whitney tests. Results: There were 23 patients with a mean age of 62.5 ± 12.2 years. The mean time from diagnosis to surgery was 97.1 ± 154.84 days. There were 12 patients in the LAAR group and 11 in the open anterior resection (OAR) group. Duration of surgery was shorter in OAR (129.58 ± 51.38 minutes) compared to LAAR (147.91 ± 39.37 minutes). Mean LOS was shorter in the LAAR group with 5±1.5 days compared to the OAR group of 7.42 ± 4.25 days. However, there was no significant P-value for both duration of surgery (P = 0.322) or LOS (P = 0.87). A total of 3 complications were recorded after OAR and 2 after LAAR. Both groups had clear proximal and distal margins with 16 (12–18.5) harvested lymph nodes in LAAR and 18 (16–22) in OAR, which were equal (P = 0.155). Conclusion This study reports a shorter LOS in the minimally invasive group of 2 days with similar oncologic resection outcomes. This shows that LAAR is feasible in Malaysia and has potential outcome benefits.