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Hysteroscopy in endometrial cancer: new methods to evaluate transtubal leakage of saline distension medium

2008; Elsevier BV; Volume: 198; Issue: 2 Linguagem: Inglês

10.1016/j.ajog.2007.07.035

1097-6868

Eugenio Solima, Valentina Brusati, Antonino Ditto, Shigeki Kusamura, Fabio Martinelli, Francesco Hanozet, Maria L. Carcangiu, Marco Maccauro, Francesco Raspagliesi,

Endometriosis Research and Treatment

This study was undertaken to evaluate transtubal fluid leakage after low pressure office saline solution hysteroscopy.Forty stage I/II endometrial cancer patients were submitted to office hysteroscopy at the National Cancer Institute of Milan. Uterine cavity was distended by a 1000-mL saline solution bag, placed 50 cm above the patient's plane. After visualization of uterine cavity, a radiotracer (technetium Tc 99m) and patent blue dye were injected subendometrially. During the staging surgery peritoneal free fluid was analyzed to detect patent blue dye, technetium Tc 99m or free cancer cell by cytologic examination.Technetium Tc 99m and patent blue dye were detected on the peritoneal surface and in the peritoneal fluid in 2 patients. In 1 of these peritoneal cytology was negative for cancer cells. Peritoneal cytology was positive in 2 cases.The risk of transtubal fluid leakage during hysteroscopy is absent when performed with intrauterine pressure less than 40 mm Hg. Transtubal fluid leakage is not a synonym of cancer cell dissemination.