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.

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.

Aims: Repeated cesarean deliveries are associated with intra-abdominal adhesions and pelvic anatomical distortion. This study evaluated vesicouterine thickness and its association with intraoperative adhesions compared with females undergoing their first cesarean delivery.Methods: This prospective observational study included 117 term pregnant female who underwent cesarean delivery between January and June 2024. Sixty-four female with at least one previous cesarean delivery comprised the previous CD group, while 53 females undergoing their first cesarean delivery comprised the primary CD group. Preoperative ultrasonographic evaluation included transvaginal measurement of vesicouterine thickness. Intraoperative adhesions were graded using the Nair adhesion scoring system. Correlation and receiver operating characteristic (ROC) analyses were performed. Results: Vesicouterine thickness was significantly lower in the previous CD group than in the primary CD group [4 (2-6) mm vs. 5 (3-7) mm, p