ObjectiveTo compare the clinical efficacy of the mechanical separation method with the energy-intervention separation method via hysteroscope in patients with moderate to severe intrauterine adhesions (IUA), to provide a reference for clinical treatment. MethodsPubmed, Medline, Embase, Cochrane Library, CNKI ,Wanfang database were searched to enroll randomized controlled trials (RCTs) on the clinical efficacy of the mechanical separation method and the energy-intervention separation method via hysteroscope in patients with moderate to severe IUA. The quality of literature was evaluated, and Meta-analysis was performed using RevMan 5.3 software. The stata 16.0 software was used for the Egger test, to analyze whether there was any publication bias. ResultsA total of 1132 patients of 14 RCTs were enrolled. Meta analysis showed that the mechanical group yielded less or lower operation time, intraoperative blood loss, volume of uterine distension fluid, recurrence rate of IUA 1 and 3 months after surgery, whereas higher total effective rate and menstrual improvement rate 3 months after surgery as compared with the energy group (all P＜0.05). ConclusionCompared to the energy-intervention separation method via hysteroscope, the hysteroscopic mechanical separation method in the treatment of moderate to severe IUA can shorten the operation time, reduce intraoperative blood loss and the volume of uterine distension fluid, reduce the recurrence rate of IUA 1 and 3 months after surgery, and improve the total effective rate and menstrual improvement rate 3 months after surgery.

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