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

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.