Background: Malnutrition is a frequent yet often overlooked comorbidity in patients undergoing surgery for colorectal cancer. It is associated with adverse postoperative outcomes, including increased complications, prolonged hospital stay, and elevated mortality. Objective: This study aimed to assess the clinical impact of short-term preoperative enteral nutrition in malnourished patients undergoing elective colorectal cancer surgery. Methods: A prospective cohort study was conducted involving 68 malnourished patients with histologically confirmed stage I–III colorectal cancer. Patients were divided into three groups: Group A (14-day enteral nutrition), Group B (7-day enteral nutrition), and Group C (no supplementation). Nutritional status, laboratory parameters, postoperative complications, transfusion needs, and hospitalization metrics were compared among groups. Results: Group A demonstrated the most favorable outcomes, including significantly fewer postoperative complications such as anastomotic leakage (5.0% vs. 17.9%, p = 0.030), reduced transfusion and albumin requirements, and shorter ICU and hospital stays (1.6 ± 0.7 and 7.1 ± 2.4 days, respectively). Group C showed the highest complication and mortality rates. Improvements in biochemical markers were observed in both intervention groups, supporting the efficacy of enteral supplementation. Conclusion: Short-term preoperative enteral nutrition significantly improves clinical outcomes in malnourished colorectal cancer patients undergoing elective surgery. These findings support the integration of nutritional screening and intervention as standard components of perioperative care in oncologic surgery.
Background: This research paper is an expression of a desire to view COVID 19 from the perspective of a spontaneous hemorrhage induced on different organ systems. Introduction of a stratified approach to the problem of hemorrhage has become an imperative in medical treatment. Aim: To determine the real figure of spontaneous hemorrhage cases in severe forms of infections caused by Covid 19.Material and methods: The research included 745 patients that suffered from severe forms of infections caused by Covid 19 who were treated in a Respiratory clinic in Tuzla University Clinical Center during 2020 and 2021. The spontaneous hemorrhage was determined on the grounds of laboratory parameters of blood counts and CRP, hemodynamic monitoring of TA and pulse, and CT imagining diagnostic technique.Results: The study presents information about the medical treatment outcome in the case of 5 patients (0,67%) who experienced spontaneous hemorrhage as a part of Covid 19 infection in relation to the total number of 745 patients who were treated during that period in the Respiratory clinic as Covid patients with severe forms of infection. Out of 5 patients who acquired spontaneous hemorrhage 3 were operated. For 4 patients the outcome was lethal. One of the female patients who was in the group of those who were not operated and who had undergone a conservative treatment has survived. In our group of analyzed patients two patients suffered from the hematoma of the front abdominal wall, two had retroperitoneal hematoma and one patient acquired hemorrhage in the abdomen and thoracic with the developing DIC.Conclusion: Relatively low percentage of cases developing spontaneous hemorrhage 5 (0, 67%) but relatively high mortality rate in the cases where it did occur, 4 out of 5 monitored patients, requires certain suggestions that are being presented in this study as to how to approach the cases of spontaneous hemorrhage in the severe forms of Covid 19 infections in more consistent manner in order to improve the outcome of the medical treatment of these cases.
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