Perioperative inflammation in gynecologic oncology: nursing strategies for enhanced recovery and complication prevention

Major gynecologic oncology surgery produces an acute inflammatory and neuroendocrine stress response superimposed on cancer-associated inflammation, frailty, malnutrition, anemia, and treatment-related physiologic vulnerability. Although this response is necessary for tissue repair, excessive or poorly resolved activation can contribute to pain, postoperative nausea and vomiting, ileus, insulin resistance, endothelial dysfunction, infection, venous thromboembolism, functional decline, and delayed return to oncologic treatment. Enhanced recovery after surgery (ERAS) pathways reduce avoidable stressors through coordinated, multimodal care, but their effectiveness depends on reliable implementation across the entire perioperative continuum. Nurses are positioned at the interfaces where risk is identified, pathway elements are delivered, trajectory deviations are recognized, and escalation occurs. This Mini Review synthesizes the inflammatory biology most relevant to gynecologic oncology nursing and translates it into practical strategies for preoperative screening and education, protocol verification, multimodal symptom control, early feeding and mobilization, infection and thromboembolism prevention, structured postoperative surveillance, and digitally supported follow-up. C-reactive protein and other inflammatory indices may complement assessment in selected pathways, but they are nonspecific and should not replace clinical evaluation or procedure-specific escalation criteria. The central proposition is that nursing care can be made inflammation-sensitive without becoming biomarker-driven: modifiable inflammatory inputs should be reduced, physiologic reserve should be preserved, self-reinforcing complication loops should be interrupted, and recovery trajectories should be monitored consistently. Future studies should test nurse-coordinated bundles using implementation, patient-reported, functional, and oncologic-process outcomes.