Comparison of postoperative infection between robotic-assisted laparoscopic prostatectomy and open radical prostatectomy.

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.