Endometrial carcinoma in a patient with post-stroke sequelae: a case report

Endometrial cancer is a common gynecologic malignancy, and surgical resection remains the mainstay of treatment. Perioperative complications such as malnutrition and venous thrombosis highlight the importance of comprehensive nursing care. Stroke sequelae, including hemiplegia, dysphagia, and impaired language function, further complicate management, especially when occurring simultaneously. However, reports addressing perioperative care in such patients are scarce. This study summarizes the perioperative nursing experience of a patient with endometrial cancer complicated by post-stroke hemiplegia, dysphagia, and impaired language deficits.

A 62-year-old postmenopausal female (gravida 2, para 2) with a history of sterilization and a 7-year hemorrhagic stroke (with sequelae of hemiplegia, dysphagia, and impaired language function) presented with 3-month vaginal bleeding. Following admission, she underwent an endometrial segmented diagnostic curettage. Postoperative pathology revealed endometrioid adenocarcinoma, International Federation of Gynecology and Obstetrics (FIGO) Stage I. The patient subsequently underwent laparoscopic hysterectomy, bilateral salpingo-oophorectomy, and sentinel lymph node mapping. Postoperatively, she was transferred to the intensive care unit (ICU) for mechanical ventilation, antimicrobial therapy, and supportive care. On postoperative day (POD) 2, extubation failed, and reintubation was performed. Given the high extubation risk due to her prior tracheostomy history, a tracheostomy was conducted on POD 4. During ICU stay, enteral nutrition was administered via NG tube and discontinued due to intolerance. POD 8, she was weaned off mechanical ventilation and transferred back to the ward.

Proactive interventions via multidisciplinary team (MDT) discussions and nursing consultations ensured postoperative airway patency for maintaining oxygenation. Key focus areas included emphasizing the importance of nutrition, addressing the patient's needs, protecting the patient's skin, and preventing pressure injuries. POD 17, the patient was discharged home with a tracheostomy tube, which was removed 1 week post-discharge. The patient was able to tolerate pureed food.

This case highlights that for patients with endometrial cancer and post-stroke sequelae undergoing Category IV procedures (laparoscopic hysterectomy, bilateral salpingo-oophorectomy, and sentinel lymph node mapping), MDT collaboration and specialist nursing consultations are critical to addressing complex perioperative care needs (airway, nutrition, skin) and achieving favorable outcomes.