Table 2 diagnostic strategy and results
Microscopic trans-sphenoidal adenomectomy | Endoscopic transsphenoidal adenomectomy | Tested difference (95% CI; p-value) | Tested difference (95% CI; p-value) (Microadenoma only) | Tested difference (95% CI; p-value) (Macroadenoma only) | |||
|---|---|---|---|---|---|---|---|
N | % | N | % | ||||
Inferior petrosal sinus sampling | 30 | 34.5 | 13 | 26.0 | 8.5 (−7.2 to 24.2; p = 0.302) | 2.4 (−17.6 to 22.4; p = 0.815) | ^ |
Radiologic imaging | p = 0.000 | p = 0.000 | p = 0.003 | ||||
-CT or X-ray | 27 | 31.0 | 1 | 2.0 | 29.0 (18.5 to 39.5) | 31.9 (19.3 to 44.5) | 16.7 (−0.5 to 33.9) |
-MRI 1.5 Tesla | 60 | 69.0 | 18 | 36.0 | 33.0 (16.5 to 49.5) | 38.7 (20.1 to 57.3) | 27.0 (−2.8 to 56.8) |
-MRI 3 Tesla | 0 | 0.0 | 31 | 62.0 | 62.0 (48.5 to 75.4) | 70.6 (55.3 to 85.9) | 43.8 (19.5 to 68.1) |
Radiology results | p = 0.144 | p = 0.359 | p = 0.339 | ||||
-Adenoma | 56 | 64.4 | 40 | 80.0 | 15.6 (0.6 to 30.6) | 14.1 (−5.2 to 33.4) | 5.6 (−5.0 to 16.2) |
-No adenoma | 24 | 27.6 | 7 | 14.0 | 13.6 (1.6 to 27.0) | 12.7 (−4.9 to 30.3) | 5.6 (− 5.0 to 16.2) |
-Inconclusive | 7 | 8.0 | 3 | 6.0 | 2.0 (−6.7 to 10.7) | 1.3 (−10.6 to 13.2) | # |
Histology results | p = 0.784 | p = 0.940 | p = 0.339 | ||||
-Adenoma | 67 | 77.9 | 41 | 82.0 | 4.1 (−9.7 to 17.9) | 0.0 (−18.2 to 18.2) | 5.6 (−5.0 to 16.2) |
-No adenoma | 16 | 18.6 | 7 | 14.0 | 4.6 (−8.1 to 17.3) | 1.5 (−15.3 to 183) | 5.6 (−5.0 to 16.2) |
-Inconclusive | 3 | 3.5 | 2 | 4.0 | 0.5 (−6.2 to 7.2) | 1.5 (−7.8 to 10.8) | # |
Immunohistochemistry results: ACTH-positive | 57 | 66.3 | 45 | 90.0 | 23.7 (10.7 to 36.7; p = 0.002) | 23.5 (6.9 to 40.1; p = 0.015) | 16.7 (−0.5 to 33.9; p = 0.087) |
Surgeon’s intraoperative findings | p = 0.123 | p = 0.231 | p = 0.447 | ||||
-Complete adenomectomy | 48$ | 58.5 | 25 | 50.0 | 8.5 (−9.0 to 26.0) | 9.8 (−10.9 to 30.5) | 8.4 (−24.9 to 41.7) |
-(At least) partial adenomectomy | 15$ | 18.3 | 18 | 36.0 | 17.7 (2.0 to 33.4) | 18.2 (−0.8 to 37.2) | 19.5 (−7.9 to 46.9) |
-Residual tumor | 4$ | 4.9 | 2 | 4.0 | 0.9 (−6.3 to 8.1) | 1.5 (−1.5 to 4.5) | 5.1 (− 19.2 to 29.4) |
-No tumor identified | 15$ | 18.3 | 5 | 10.0 | 8.3 (−3.5 to 20.1) | 6.8 (−8.7 to 22.3) | 5.9 (−5.3 to 17.1) |