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

<b>Background</b>: 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. <b>Methods</b>: 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. <b>Results</b>: A total of 131 patients were included [immunonutrition group, <i>n</i> = 69; control group, <i>n</i> = 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 [<i>p</i> = 0.24]. By the 6th postoperative week, complete healing rates were comparable [96.6% vs. 93.1%, <i>p</i> = 0.43]. In multivariable analysis, vaginal cuff closure time was independently associated with delayed cuff healing [<i>p</i> = 0.02]. Postoperative morbidity did not differ between groups. <b>Conclusions</b>: Vaginal cuff healing after laparoscopic surgery for endometrial cancer was primarily influenced by surgical factors, particularly vaginal cuff closure time, rather than postoperative immunonutrition.