Duan Hua, Li Wei, Zhang Ying, Zhao Xia, Xia En-Lan
Department of Minimally Invasive Gynecology, Beijing Obstetrics and Gynecology Hospital, Capital University of Medical Sciences, Beijing 100006, China.
Zhonghua Fu Chan Ke Za Zhi. 2007 Feb;42(2):99-101.
To study prospectively the likelihood and the affecting factors of endometrial cell dissemination into the peritoneal cavity during hysteroscopic procedures.
A total of 121 patients with benign endometrial pathology underwent hysteroscopy combined with laparoscopy. All the patients had pelvic washings performed just before and after the procedure of hysteroscopy. We collected the peritoneal washings and analyzed the peritoneal cytology changes in both groups pre- and post-hysteroscopy, as well as the dissemination rate related to the time of hysteroscopy, the intrauterine distention pressure, the volume of distention media, and the feature of endometrial conditions.
The ratio of positive endometrial cells in the peritoneal washings of post-hysteroscopy group was 51.2% (62/121), which was significantly higher than pre-hysteroscopy group, 38.0% (46/121) (P < 0.01). The mean operation time in the group of positive peritoneal cytology was (38 +/- 16) min, longer than the negative group (P < 0.05). However, there was no significant difference between the two groups with regard to the total volume of distention media, the distention pressure, and the endometrial feature (P > 0.05).
Hysteroscopic procedures may have a risk of disseminating the endometrial cells into peritoneal cavity. Under a certain uterine distention pressure, the rate of dissemination is correlated with hysteroscopic duration.
前瞻性研究宫腔镜手术过程中子宫内膜细胞播散至腹腔的可能性及影响因素。
121例患有良性子宫内膜病变的患者接受了宫腔镜联合腹腔镜检查。所有患者在宫腔镜手术前后均进行了盆腔冲洗。我们收集了腹腔冲洗液，分析了宫腔镜检查前后两组的腹腔细胞学变化，以及与宫腔镜检查时间、宫内扩张压力、扩张介质体积和子宫内膜状况特征相关的播散率。
宫腔镜检查后组腹腔冲洗液中子宫内膜细胞阳性率为51.2%（62/121），显著高于宫腔镜检查前组的38.0%（46/121）（P<0.01）。腹腔细胞学阳性组的平均手术时间为（38±16）分钟，长于阴性组（P<0.05）。然而，两组在扩张介质总体积、扩张压力和子宫内膜特征方面无显著差异（P>0.05）。
宫腔镜手术可能存在将子宫内膜细胞播散至腹腔的风险。在一定的子宫扩张压力下，播散率与宫腔镜检查持续时间相关。
