Background/aim: Enteral feeding and immunonutrition (ImN) have been shown to be associated with a number of favorable effects in patients undergoing cancer surgery. In this prospective study, we aimed to assess the perioperative use of enteral immunonutrition in patients undergoing radical gastrointestinal surgery for malignancy.Materials and methods: Forty-one patients with malignancy were included in this study and were randomized into one of the two following nutritional strategies: enteral only (EN) or enteral with enteral immunonutrition (ENIN). These regimens were followed for 7 days perioperatively by all patients. Nutritional parameters and postoperative morbidity, mortality, and length of hospital stay (LHS) were assessed.Results: Serum prealbumin levels increased significantly in the ENIN group (P = 0.033). Moreover, patients in the ENIN group showed a more marked decrease in the rate of postoperative infections (P = 0.021) and anastomotic leakage (P = 0.018) than patients fed with EN. In the EN group, LHS was significantly longer than that in the ENIN group (18 vs. 12 days) (P = 0.032). Rates of overall morbidity and mortality were similar in the two groups (P > 0.05). Conclusion:ENIN was found to have a favorable effect on the outcome of radical gastrointestinal surgery for malignancy. Meticulous preoperative assessment of malnutrition and at least a 7-day perioperative enteral use can increase the effectiveness of immunonutrition.

HighlightsColonic metastasis of the renal cell carcinoma (RCC) following curative nephrectomy is an extremely rare.Early diagnosis of colonic metastasis of the RCC is an important for survival.Surgical resection is a effective treatment method for colonic metastasis of the RCC.

We concluded that in experienced hand, LC with three ports is safe and feasible technique if it is not endanger the course of the surgery.

Background Sclerosing angiomatoid vascular transformation (SANT) is a rare vascular disease of the spleen, which is difficult to diagnose due to its pre-intervention appearance of malignancy. Case Report: An 85-year-old male was transferred to our clinic for thrombocytopenia and splenic mass. A contrast enhanced abdominal CT and MRI showed nodular lesions, the largest 50mm in diameter, and several areas of heterogeneous contrast field involvement in the spleen parenchyma. Laparoscopic splenectomy was performed with normal range of platelet level. The patient's postoperative course was uneventful and he was discharged on the 6th postoperative day. Histopathology revealed SANT. The patient is now in the 18 th month of remission with platelet levels within normal range and with no recurrence. Results Between 2004 and April 2020, a total of 230 SANT patients who underwent laparoscopic or open splenectomy or biopsy were reported in the literature. Most patients were female (52.1%), and the median age was 46 years (9 weeks-85 years). Most patients were asymptomatic (56%). Open splenectomy was performed on 166 patients (72.1%),laparoscopic splenectomy on 35 patients (15.2%) and laparoscopic partial splenectomy on 15 patients (6.5%). The median operation time and spleen weight were 143 minutes (88-213) and 260gr (68-2,720), respectively. Median follow-up time was 12 months (0-166). No recurrence was seen in patients undergoing total splenectomy. Conclusion SANT is an unusual disease of the spleen. In the light of this systematic review, a minimally invasive method for total or partial splenectomy,specifically laparoscopy, can be preferred as the treatment of choice.

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