European Society of Gynecological Oncology Consensus Statement on the prevention of surgical complications in gynecologic oncology.

OBJECTIVE

Surgical intervention remains the cornerstone of treatment for gynecologic malignancies. However, the complex nature of these procedures leads to a significant risk of perioperative and post-operative complications. The European Society of Gynecological Oncology recognized the need for standardized, evidence-based consensus statements with the aim to minimize surgical morbidity and mortality and decrease surgical complications.

METHODS

A literature review was conducted by the methodologist of the group, using the MEDLINE database, based on 5 patient, intervention or exposure, comparison or control, outcome frameworks. Literature published between January 1, 2014, and June 1, 2025, was reviewed and critically appraised. The literature search was limited to publications in English. Priority was given to high-quality systematic reviews, meta-analyses, and randomized controlled trials, but studies with less evidence, such as prospective cohort studies and retrospective registry-based analyses, were also evaluated. Statements were subsequently drafted collaboratively based on the review of the literature and adapted in an iterative process in conference call meetings including anonymous voting for each statement.

RESULTS

The group achieved consensus on 26 statements categorized into six primary surgical domains: Energy Devices and Surgical Environment, Minimally Invasive Entry Techniques, Use of Uterine Manipulators, Lymphedema Prevention and Management, Vulvar Surgery and Wound Management, and Inguinal Lymphadenectomy.

CONCLUSIONS

This Consensus Statement presents comprehensive guidelines for the prevention of surgical complications in gynecologic oncology. These recommendations are expected to standardize surgical care, reduce perioperative morbidity and lead to improvement of post-operative recovery and ultimately quality of life of patients with gynecologic malignancies.