Comparison of Postoperative Infection between Robotic-Assisted Laparoscopic Prostatectomy and Open Radical Prostatectomy

Abstract

Background: Robotic-assisted laparoscopic prostatectomy (RALP) has been rapidly adapted worldwide. The purpose of this study was to investigate postoperative infection (POI) after RALP and compare it with that after open radical prostatectomy (ORP). Methods: 89 consecutive RALP cases and 105 recent ORP cases were enrolled. POIs were categorized according to CDC guideline criteria. Laboratory data relating to infection such as serum white blood cells (WBC) and C-reactive protein (CRP) were comparatively investigated before and after the surgeries. Data were collected and analyzed retrospectively. Results: There was one surgical site infection patient in the RALP cases (1/89, 1.12%). ORP cases had a comparatively higher ratio of POI (6/105, 4.77%), but the difference did not reach statistical significance (p = 0.0876). The postoperative rise of serum WBC (postoperative days 1 and 4) and CRP (postoperative days 1, 4 and 7) was significantly suppressed from pre-surgery data in RALP when compared to ORP. Conclusions: RALP tended to have a lower rate of POI than ORP even though this change was not statistically significant and the postoperative rise of serum WBC and CRP was significantly suppressed in RALP compared to ORP. A prospective study with a standardized prophylactic antibiotic administration may be necessary for further evaluation of potential guidelines for RALP.

Post-surgical outcomes of patients with chronic kidney disease and end stage renal disease undergoing radical prostatectomy: 10-year results from the US National Inpatient Sample

“…A previous study of NIS data from 2001 to 2007 found that patients who received minimally invasive surgery (as compared to open surgery) had a shorter length of stay (OR = 0.61, 95% CI: 0.54–0.69, p < 0.001) [20]. Similarly, one study from Japan compared 89 consecutive cases of RARP with 105 cases of open surgery; those receiving RARP had fewer postoperative infections, although the results were not significant [21]. A previous meta-analysis of two single-setting studies ( n = 446) found slight improvement in certain postoperative outcomes of RARP versus ORP and concluded that this “probably” was associated with reduced length of hospital stay [11].…”

Long‐term adverse effects after retropubic and robot‐assisted radical prostatectomy. Nationwide, population‐based study

“…To date, most studies have shown similar risk for urinary incontinence and erectile dysfunction after RRP and RARP but recent systematic reviews on observational studies have suggested that urinary incontinence and erectile dysfunction are less frequent after RARP than RRP . Compared to RRP, RARP is associated with shorter postoperative hospital stay, less perioperative bleeding, fewer postoperative infections, and fewer thromboembolic events, whereas the operating time is shorter and direct costs are lower for RRP . Radical prostatectomy increases the risk of inguinal hernia but it is unclear if there is any difference in risk after RRP and RARP .…”

“…19 A recent single center randomized clinical trial from Australia showed similar short-term results after RRP and RARP. 20 However, only outcomes at up to 12 weeks were reported in that study and there are currently little data on long-term adverse effects after RRP and RARP other than for urinary incontinence and erectile dysfunction.…”

Surgical site infections after radical prostatectomy: A comparative study between robot-assisted laparoscopic radical prostatectomy and retropubic radical prostatectomy

“…[23] In a similar earlier published study, the SSI rate reported for the RRP group was 4.7% while the SSI rate in the current study it was 14.4%. [24] SSI rates in RALP and RRP were 1.12% vs. 4.77% with a statistically insignificant difference between groups (p=0.0876). [24] The reason for the higher SSI rates in our analysis can be explained as follows: 1.…”

“…[24] SSI rates in RALP and RRP were 1.12% vs. 4.77% with a statistically insignificant difference between groups (p=0.0876). [24] The reason for the higher SSI rates in our analysis can be explained as follows: 1. Two centers agreed to take a detailed digital patient history.…”