title: The Accuracy of Large Loop Excision of the Transformation Zone Specimen Dimensions in Determining Volume: A Multicentric Prospective Observational Study.
abstract: OBJECTIVE
  The aim of the study was to determine which mathematical formula of specimen dimensions is the most accurate method of determining volume of the excised specimen at loop excision of the transformation zone.
  
  
  METHODS
  A multicenter prospective observational study was conducted. A total of 258 patients who had a loop excision of the transformation zone performed as treatment of cervical intraepithelial neoplasia 2-3 were included. The dimensions and the volume of the specimen were measured at the time of the procedure, before formaldehyde fixation. The volume was measured by immersing the specimen in a graduated cylinder using Archimedes fluid displacement technique. The measured volume was compared with the calculated volume using different volume formulas, that is, a cone, a cylinder, a parallelepiped, and a hemiellipsoid. The main outcome measure was the relationship between calculated volume (using the dimensions of thickness, length, and circumference) and the measured volume of the specimen.
  
  
  RESULTS
  The mean (SD) thickness, length, and circumference of specimens were 8.8 mm (3.8), 12.7 mm (5.9), and 45.7 mm (16.8), respectively. The mean (SD) measured volume was 2.53 (1.49) mL. Using the formula for the volume of a cone, a cylinder, a parallelepiped and a hemiellipsoid, estimated volumes were 1.03 mL (1.22), 3.10 mL (3.65), 6.20 mL (7.31), and 2.07 mL (2.44), respectively. The highest intraclass correlation coefficient between measured and calculated volume was observed when using the formula for the volume of a hemiellipsoid specimen (0.47, 95% CI = 0.36-0.56).
  
  
  CONCLUSIONS
  The hemiellipsoid formula is the most accurate determinant of the excised volume. Other formulas do not allow for an accurate estimation of the excised volume.
authors.affiliation: 1Department of Obstetrics and Gynaecology, Hôpital Nord, APHM, Aix-Marseille University (AMU), CNRS, IRD, Marseille, France; 2Aix Marseille University, Inserm, IRD, Marseille, France; 3APHM, Hôpital de la Timone, Public Health Department, BioSTIC, Marseille, France; 4International Agency for Research on Cancer, World Health Organization, Lyon, France; 5University Hospital of Amiens, Jules Verne University, Picardie, France; 6Department of Obstetrics and Gynaecology, Femme Mère Enfant University Hospital, Lyon-Bron, France; 7Teaching Hospital of Rennes, Gynaecologic Department, University of Rennes 1, Rennes, France; 8Department of Obstetrics and Gynaecology, Hospital of Hautepierre, Strasbourg University Hospitals, Strasbourg, France; 9Department of Pathology, CHU Pontchaillou, Rennes, France; 10Department of Obstetrics and Gynaecology, Hopital La Conception, APHM, Aix-Marseille University, Marseille, France; 11Department of Gynaecologic and Oncologic Surgery, CHU Dijon, France; 12Pôle Mère-Femme, University Hospital Jean Minjoz, Besançon, France; and 13Pôle d'Obstétrique Reproduction Gynécologie, Centre Aliénor d'Aquitaine, Hôpital Pellegrin, Bordeaux, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Carcopino
authors.forename: Julien
authors.initials: J
authors.lastname: Mancini
authors.forename: Walter
authors.initials: W
authors.lastname: Prendiville
authors.forename: Jean
authors.initials: J
authors.lastname: Gondry
authors.forename: Julien
authors.initials: J
authors.lastname: Chevreau
authors.forename: Gery
authors.initials: G
authors.lastname: Lamblin
authors.forename: Anthony
authors.initials: A
authors.lastname: Atallah
authors.forename: Vincent
authors.initials: V
authors.lastname: Lavoue
authors.forename: Claire
authors.initials: C
authors.lastname: Caradec
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Baldauf
authors.forename: Angélique
authors.initials: A
authors.lastname: Bryand
authors.forename: Sébastien
authors.initials: S
authors.lastname: Henno
authors.forename: Aubert
authors.initials: A
authors.lastname: Agostini
authors.forename: Serge
authors.initials: S
authors.lastname: Douvier
authors.forename: Adelaide
authors.initials: A
authors.lastname: Jarniat
authors.forename: Didier
authors.initials: D
authors.lastname: Riethmuller
authors.forename: Anne
authors.initials: A
authors.lastname: Mendel
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Brun
authors.forename: Hajanarina
authors.initials: H
authors.lastname: Rakotomahenina
authors.forename: Lise
authors.initials: L
authors.lastname: Preaubert
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008875:Middle Aged; D008962:Models, Theoretical; D010336:Pathology / Q000379:methods*; D011446:Prospective Studies; D013048:Specimen Handling / Q000379:methods*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000601:surgery*