{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T08:09:33Z","timestamp":1792138173931,"version":"4.4.0"},"reference-count":32,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,6,21]],"date-time":"2021-06-21T00:00:00Z","timestamp":1624233600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To determine whether hysteroscopy (HSC) increases the risk of intraperitoneal dissemination in endometrial cancer patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a comprehensive review of multiple databases. Quality assessments of eligible studies were performed using the Newcastle\u2010Ottawa and Jadad scales. Positive peritoneal cytology (PPC) as the outcome of interest was compared between endometrial cancer patients with and without HSC. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated as a measure of effects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Three case\u2013control studies and eight retrospective cohort studies included 3364 patients, of whom 1116 underwent preoperative HSC, which resulted in a significantly higher PPC rate (OR, 1.82; 95% CI, 1.31\u20132.54; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.0004). I<jats:sup>2<\/jats:sup> was 11%, and the heterogeneity was acceptable. The difference between the groups with stages I\u2013II was statistically insignificant (OR, 1.50; 95% CI, 0.75\u20132.99; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.25). When liquid was used as the uterine distension medium during HSC and the intrauterine pressure was controlled under 80\u2009mmHg, the difference between the two groups was also insignificant (OR, 1.18; 95% CI, 0.50\u20132.79; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.71). However, when the intrauterine pressure exceeded 80\u2009mmHg, the difference between the two groups was statistically significant (OR, 2.18; 95% CI, 1.28\u20133.73; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.004).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This meta\u2010analysis indicates that preoperative HSC in patients with endometrial cancer may increase the risk of intraperitoneal dissemination of malignant cells, which may be associated with intrauterine pressure &gt;80\u2009mmHg but not with stages I\u2013II. There is no reason to avoid HSC for the diagnosis of endometrial cancer, especially in early stages, but intrauterine pressure should possibly be controlled below 80\u2009mmHg.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jog.14897","type":"journal-article","created":{"date-parts":[[2021,6,22]],"date-time":"2021-06-22T03:52:35Z","timestamp":1624333955000},"page":"2969-2977","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Whether preoperative hysteroscopy increases the dissemination of endometrial cancer cells: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"47","author":[{"given":"He","family":"Dong","sequence":"first","affiliation":[{"name":"Department of Gynecologic Oncology The First Hospital of Jilin University  Changchun China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongxin","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Gynecologic Oncology The First Hospital of Jilin University  Changchun China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingyue","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Gynecologic Oncology The First Hospital of Jilin University  Changchun China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengzi","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Statistics, School of Public Health Jilin University  Changchun China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Yue","sequence":"additional","affiliation":[{"name":"Department of Gynecologic Oncology The First Hospital of Jilin University  Changchun China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,6,21]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21492"},{"key":"e_1_2_8_3_1","unstructured":"IARC WHO.Cancer fact sheets.2018.https:\/\/gco.iarc.fr\/today\/data\/factsheets\/cancers\/24-Corpus-uteri-fact-sheet.pdf. 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