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 im-mune-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 prospective-ly. Results: A total of 127 patients were included [immunonutrition group, n = 66; control group, n = 61]. At the 4th postoperative week, complete vaginal cuff healing was observed in 86.2% of the immunonutrition group and 74.6% of the control group [p = 0.17]. By the 6th postoperative week, complete healing rates were comparable [96.7% vs. 93.8%, p = 0.72]. In multivariable analysis, vaginal cuff closure time was independently associated with delayed cuff healing [p = 0.02]. Postoperative morbidity did not differ between groups. Conclusion: Vaginal cuff healing after laparoscopic surgery for endometrial cancer was primarily influenced by surgical factors, particularly vaginal cuff closure time, rather than postoperative immunonutrition.