\(=\dfrac{\left(5\sqrt{a}-3\right)\left(\sqrt{a}+3\right)+\left(3\sqrt{a}+1\right)\left(\sqrt{a}-2\right)-a^2-2\sqrt{a}-8}{a-4}\)
\(=\dfrac{5a+15\sqrt{a}-3\sqrt{a}-9+3a-6\sqrt{a}+\sqrt{a}-2-a^2-2\sqrt{a}-8}{a-4}\)
\(=\dfrac{-a^2+8a+5\sqrt{a}-19}{a-4}\)