To add or subtract expressions, expand them to make their denominators the same. Least common multiple of $x^{2}+3x+9$ and $x^{2}-3x+9$ is $\left(x^{2}-3x+9\right)\left(x^{2}+3x+9\right)$. Multiply $\frac{x+3}{x^{2}+3x+9}$ times $\frac{x^{2}-3x+9}{x^{2}-3x+9}$. Multiply $\frac{x-3}{x^{2}-3x+9}$ times $\frac{x^{2}+3x+9}{x^{2}+3x+9}$.
Since $\frac{\left(x+3\right)\left(x^{2}-3x+9\right)}{\left(x^{2}-3x+9\right)\left(x^{2}+3x+9\right)}$ and $\frac{\left(x-3\right)\left(x^{2}+3x+9\right)}{\left(x^{2}-3x+9\right)\left(x^{2}+3x+9\right)}$ have the same denominator, add them by adding their numerators.
Since $\frac{2x^{3}}{\left(x^{2}-3x+9\right)\left(x^{2}+3x+9\right)}$ and $\frac{54}{\left(x^{2}-3x+9\right)\left(x^{2}+3x+9\right)}$ have the same denominator, subtract them by subtracting their numerators.
To add or subtract expressions, expand them to make their denominators the same. Least common multiple of $x^{2}+3x+9$ and $x^{2}-3x+9$ is $\left(x^{2}-3x+9\right)\left(x^{2}+3x+9\right)$. Multiply $\frac{x+3}{x^{2}+3x+9}$ times $\frac{x^{2}-3x+9}{x^{2}-3x+9}$. Multiply $\frac{x-3}{x^{2}-3x+9}$ times $\frac{x^{2}+3x+9}{x^{2}+3x+9}$.
Since $\frac{\left(x+3\right)\left(x^{2}-3x+9\right)}{\left(x^{2}-3x+9\right)\left(x^{2}+3x+9\right)}$ and $\frac{\left(x-3\right)\left(x^{2}+3x+9\right)}{\left(x^{2}-3x+9\right)\left(x^{2}+3x+9\right)}$ have the same denominator, add them by adding their numerators.
Since $\frac{2x^{3}}{\left(x^{2}-3x+9\right)\left(x^{2}+3x+9\right)}$ and $\frac{54}{\left(x^{2}-3x+9\right)\left(x^{2}+3x+9\right)}$ have the same denominator, subtract them by subtracting their numerators.