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Transtubal Transport of Carcinoma Cells Into the Peritoneal Cavity After Saline Infusion via Transcervical Route in Patients With Endometrial Carcinoma
  1. Tugan Bese, MD*,
  2. Fuat Demirkiran, MD*,
  3. Onur Guralp, MD,
  4. Cevdet Sanioglu, MD* and
  5. Macit Arvas, MD*
  1. *Gynecologic Oncology Division, and
  2. Obstetrics and Gynecology Department, Cerrahpaşa Medical School, Istanbul University, Istanbul, Turkey.
  1. Address correspondence and reprint requests to Onur Guralp, Akademiler Sit. B/37 kat: 8 Zincirlikuyu, Istanbul, Turkey. E-mail: dronur{at}


The aim of this study was to evaluate the rate of transtubal passage of carcinoma cells into the abdominal cavity after saline infusion in patients with endometrial carcinoma.

Forty-four patients with primary endometrial carcinoma, who had been planned to be operated on, were included into this study. A pediatric foley catheter was inserted into the endometrial cavity via cervical route just before laparotomy. During laparotomy, fallopian tubes, on both sides, were inserted into 2 separate plastic bags. A maximum of 150 mL (range, 20-150 mL) of saline was infused into the endometrial cavity via foley catheter by a syringe. Fluid running off through the fallopian tubes was collected separately.

Transtubal fluid passage was detected in 24 (54.5%) of 44 patients. In all patients without tubal passage, the initial results of peritoneal washing cytology were negative. On the other hand, the initial (in vivo) results of peritoneal cytology were positive in 2 of 24 patients in whom transtubal saline transport was detected. After the procedure, in 6 (25%) of 24 patients with transtubal passage, cytological examination revealed malignant cells in the collected fluid through the tubes. In all patients, in whom transtubal passage was not observed, tumor localization was fundal. However, in 6 of 24 patients with transtubal passage, there were different locations.

We suggest that saline infusion sonohysterography can cause dissemination of malignant cells into the abdominal cavity.

  • Saline infusion sonohysterography
  • Endometrial carcinoma dissemination
  • Transtubal transport
  • Peritoneal cytology

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