Postoperative Vaginal Cuff Healing After Minimally Invasive Surgery for Endometrial Cancer: The Role of Postoperative Immunonutrition

TL;DR

This study found that postoperative immunonutrition does not significantly improve vaginal cuff healing after laparoscopic surgery for endometrial cancer.

Contribution

The study provides evidence that surgical factors, not immunonutrition, mainly affect vaginal cuff healing in endometrial cancer patients.

Findings

Complete vaginal cuff healing rates were similar between immunonutrition and control groups at 4th and 6th weeks.

Vaginal cuff closure time was independently associated with delayed healing in multivariable analysis.

Postoperative complications did not differ between the two groups.

Abstract

Background: This study aimed to evaluate the impact of postoperative immunonutrition on vaginal cuff healing in well-nourished patients undergoing laparoscopic surgery for endometrial cancer. The secondary objective was to assess postoperative complications occurring within 30 days. Methods: This prospective observational cohort study included patients who underwent laparoscopic surgery for endometrial cancer. Patients receiving postoperative oral immune-modulating diets were compared with those managed with a standard postoperative diet. Vaginal cuff healing assessed at postoperative 4th and 6th weeks. Postoperative complications within 30 days were recorded prospectively. Results: A total of 131 patients were included [immunonutrition group, n = 69; control group, n = 62]. At the 4th postoperative week, complete vaginal cuff healing was observed in 84.1% of the immunonutrition group and 75.8% of the control group [p = 0.24]. By the 6th postoperative week, complete healing rates were comparable [96.6% vs. 93.1%, p = 0.43]. In multivariable analysis, vaginal cuff closure time was independently associated with delayed cuff healing [p = 0.02]. Postoperative morbidity did not differ between groups. Conclusions: Vaginal cuff healing after laparoscopic surgery for endometrial cancer was primarily influenced by surgical factors, particularly vaginal cuff closure time, rather than postoperative immunonutrition.

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