Incidence and Risk Factors for Perioperative Infections After Robot-Assisted Radical Prostatectomy: A Multicenter...

Area of Science:

• Urology
• Surgical Oncology
• Infectious Diseases

Background:

• Robot-assisted radical prostatectomy (RARP) is a common procedure.
• Understanding perioperative infection risks is crucial for patient outcomes.
• Antimicrobial prophylaxis patterns and their effectiveness require evaluation.

Purpose of the Study:

• To assess the incidence of perioperative infections following RARP.
• To analyze antimicrobial prophylaxis strategies used in Japan.
• To identify risk factors associated with infections after RARP.

Main Methods:

• Retrospective analysis of 6660 patients undergoing RARP (2009-2021).
• Evaluation of cefazolin (CEZ), ampicillin/sulbactam (ABPC/SBT), and second-generation cephalosporins (2ndCPs) prophylaxis.
• Assessment of surgical site infections (SSI), urinary tract infections (UTI), and remote infections (RI) within 30 days; logistic regression for risk factors.

Main Results:

• Overall infection rates: SSI 1.2%, UTI 1.4%, RI 0.3%.
• Superficial SSI was common; deep/organ/space SSI was rare.
• No significant SSI difference between ≤24h and >24h prophylaxis. Bowel injury linked to SSI; high BMI, catheter issues, and ABPC/SBT use linked to UTI.

Conclusions:

• Perioperative infection rates after RARP are low.
• Prophylaxis within 24 hours, especially with CEZ or 2ndCPs, may be adequate.
• Preventing bowel injury and optimizing catheter management can further decrease infection risk.