Hysteroscopy in endometrial cancer: new methods to evaluate transtubal leakage of saline distension medium.
OBJECTIVE
This study was undertaken to evaluate transtubal fluid leakage after low pressure office saline solution hysteroscopy.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Solima
Eugenio
E
Department of Gynecologic Oncology, Istituto Nazionale Tumori, Milan, Italy.
Brusati
Valentina
V
Ditto
Antonino
A
Kusamura
Shigeki
S
Martinelli
Fabio
F
Hanozet
Francesco
F
Carcangiu
Maria L
ML
Maccauro
Marco
M
Raspagliesi
Francesco
F
D000230:Adenocarcinoma / Q000473:pathology*; D000328:Adult; D000368:Aged; D016889:Endometrial Neoplasms / Q000473:pathology*; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000209:etiology*; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D009366:Neoplasm Seeding; D009367:Neoplasm Staging; D011446:Prospective Studies; D012965:Sodium Chloride / Q000008:administration & dosage*
D012965:Sodium Chloride