Background/Objectives: Composite hemangioendothelioma (CHE) is a rare vascular endothelial tumor with borderline malignancy. This study presents a case of CHE and an updated systematic review of previously reported cases, providing insights into recurrence patterns and survival outcomes. Methods: A comprehensive electronic search was conducted across PubMed, Scopus, the Cochrane Library, and Web of Science up to 31 December 2024, to identify eligible case reports. Kaplan–Meier curves were used to estimate event-free survival. Results: We report a 61-year-old man with a splenic lesion associated with weight loss and abdominal pain persisting for 1 year. Intraoperative findings revealed an enlarged spleen and multiple hepatic deposits. Splenectomy and liver biopsy revealed a well-demarcated, nodular tumor measuring 160 × 145 × 100 mm, with histological and immunohistochemical findings consistent with CHE, complicated by hepatic metastasis. Of 405 potentially eligible studies, 59 were included in the review, covering cases from 2000 to 2024, with a peak in 2020 and 2023. The median age of patients was 42 years, with the most common tumor sites being the lower extremities (30.48%), followed by the face, head, and neck (20.95%), and upper extremities (18.1%). Surgical intervention was the most common treatment (60.95%). Recurrence-free survival was observed in 42.86% of cases, while 15.24% experienced recurrence with or without metastasis. Two patients (1.90%) died from the disease. The median recurrence-free survival was 48 months (95% CI: 7.3–88.7). Conclusions: CHE exhibits significant morphological variation and can mimic other vascular tumors. Accurate diagnosis is crucial for proper prognosis and avoiding overtreatment due to misdiagnosis as more aggressive neoplasms. Patients with high-risk CHE should undergo closer surveillance to ensure timely detection of progression.

Backround/Objectives: Colorectal cancer presents a significant quality of life (QoL) challenge as a result of both the disease and its treatments. This study aimed to validate and culturally adapt the Cleveland Clinic Colorectal Cancer Quality of Life Questionnaire (CCF-CaQL) for Serbian-speaking colorectal cancer patients. Methods: The CCF-CaQL offers a detailed assessment of the physical, emotional, social, and functional impacts of the disease. This study, conducted at the University Clinical Center of Serbia, involved 150 colorectal cancer patients undergoing treatment. The translation and adaptation process followed the EORTC Quality of Life Group’s guidelines, ensuring cultural relevance and comprehensibility. Statistical analyses, including Cronbach’s alpha for internal consistency and Pearson’s correlation for concurrent validity, reliability, and known-groups validity, were performed using SPSS and R software. Results: The Serbian version of the CCF-CaQL maintains strong psychometric properties with high internal consistency (Cronbach’s alpha = 0.85) and significant correlations with the FACT-C questionnaire, confirming its validity. Known-groups validity showed distinct variations in QoL scores based on tumor location, stoma presence, and neoadjuvant therapy status, highlighting its sensitivity to different clinical conditions. Conclusions: The CCF-CaQL questionnaire has been skillfully translated, culturally adapted, and carefully validated through psychometric evaluations for Serbian patients diagnosed with colorectal cancer.

Background/Objectives: Antibiotic prophylaxis is a key component of infection prevention strategies. This study aimed to evaluate whether the duration of antibiotic prophylaxis influences the incidence of HAIs in patients undergoing elective colorectal surgery. Methods: This prospective cohort study included 278 adult patients who underwent elective colorectal surgery at a single tertiary care center. Patients were categorized into two groups based on the duration of antibiotic prophylaxis: one day or more than one day. Data on demographics, clinical characteristics, perioperative variables, and infection outcomes were collected. Results: The overall incidence of HAIs was 16.9%, with no significant difference between patients receiving one-day versus extended antibiotic prophylaxis. However, traditional multivariate analysis showed that prophylaxis lasting more than one day was independently associated with a significantly lower risk of HAI (RR = 0.30, 95% CI: 0.12–0.75, p = 0.010) and surgical site infections (RR = 0.24, 95% CI: 0.08–0.72, p = 0.011). After adjusting for confounders using propensity score matching, this association was no longer statistically significant. No significant association was found between prophylaxis duration and urinary tract infections. Regarding antibiotic selection, first-generation cephalosporins were the most commonly used agents, accounting for 78.8% of prophylactic prescriptions. This was followed by fluoroquinolones (14.4%) and third-generation cephalosporins (5.0%). All patients received metronidazole, a nitroimidazole-class antimicrobial, in combination with the above agents. Conclusions: One day of prophylactic antibiotics may be sufficient in SSI prevention in patients undergoing elective colorectal surgery. The use of extended antibiotic prophylaxis beyond one day should be considered for high-risk patients at high risk of infection, particularly those requiring ICU care.

Background/Objectives: Postoperative urinary tract infections (UTIs), particularly catheter-associated UTIs (CAUTIs), are potentially preventable complications of colorectal surgery. This study evaluated their incidence, timing, microbiology, antimicrobial resistance, and associated factors among patients undergoing colorectal cancer surgery. Methods: This prospective cohort study included 300 patients undergoing colorectal cancer surgery at a Serbian tertiary hospital. Associations with postoperative UTI, defined according to ECDC criteria, were examined using Firth penalized logistic regression and cause-specific Cox regression, with cumulative catheter exposure modeled as a time-dependent covariate. Results: Nineteen patients (6.3%) developed postoperative UTI, including 17 CAUTIs (89.5%) and two asymptomatic bacteriuria. The incidence rates of all UTIs and CAUTIs were 12.0 (95% confidence interval [CI], 7.2–18.8) and 10.8 (95% CI, 6.3–17.2) per 1000 catheter-days, respectively. Seventeen infections occurred by postoperative day 30, and no additional events occurred after day 45. In the multivariable Firth penalized logistic regression model, cumulative catheter exposure per five catheter-days (adjusted odds ratio [aOR], 1.45; 95% CI, 1.17–1.84), operative duration per 30 min (aOR, 1.59; 95% CI, 1.13–2.21), and preoperative leukocyte count (aOR, 1.20; 95% CI, 1.02–1.42) were associated with UTI. In the primary Cox model, cumulative catheter exposure (adjusted hazard ratio [aHR], 2.66; 95% CI, 2.03–3.50) and operative duration (aHR, 1.60; 95% CI, 1.16–2.21) remained associated with postoperative UTI after adjustment for the other covariates included in the model. Gram-negative organisms predominated, with notable third-generation cephalosporin and carbapenem resistance among Klebsiella–Enterobacter isolates. Conclusions: Most surveillance-defined postoperative UTI events were symptomatic and catheter-associated. Greater cumulative catheter exposure and longer operative duration showed consistent associations with UTI across exploratory models. These findings support careful review of catheter necessity but require confirmation in larger cohorts.