To assess the efficacy and safety of using energy devices as treatment for radiation-induced hemorrhagic cystitis (RHC) and to determine the most suitable energy source, settings and techniques based on laser-tissue interaction. A search of Google Scholar, PubMed, and Web of Science databases was conducted uptil February 2024 to identify studies on use of energy devices for RHC.Additionally, ClinicalTrials.gov and the World Health Organization’s ICTRP (International Clinical Trials Registry Platform) were searched for ongoing studies. We identified 10 studies fulfilling the search criteria using modalities including Nd:YAG laser, argon plasma coagulation, 980-nm diode laser, and potassium-titanyl-phosphate (KTP) laser. Across studies (n=137), majority (n=116, 84.7%) of RHC patients achieved hematuria resolution after one treatment session, with mean/median hematuria-free intervals of 11 to 16 months. Six patients (4.4%) were unresponsive and underwent cystectomy/urinary diversion. Total adverse events occurred in patients (30/139, 21.6%), including storage symptoms, recurrent hematuria, bladder stones and urinary retention, among others. Typical laser settings involved low power (<40 W), with either a pulse duration of 2–3 seconds or 10–40 milliseconds; some used continuous wave mode. Other standard practises include selective coagulation employed in a “painting” fashion and non-contact mode (3–5 mm). The treatment endpoints were hemostasis, involution of telangiectatic vessels and formation of pale well-circumscribed mucosal ulcer. Energy devices have considerable efficacy and safety to treat RHC patients and can be considered for refractory RHC and as an adjunct after initial management. The various properties of KTP laser confers an advantage over other energy devices.

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.