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.

1.
Yoshioka K, Hatano T, Nakagami Y, Ozu C, Horiguchi Y, Sakamoto N, Yonov H, Ohno Y, Ohori M, Tachibana M, Patel VR: First 24 Japanese cases of robotic-assisted laparoscopic radical prostatectomy using the daVinci Surgical System. Hinyokika Kiyo 2008;54:333-338.
2.
Hegarty NJ, Kaouk JH: Radical prostatectomy: a comparison of open, laparoscopic and robot-assisted laparoscopic techniques. Can J Urol 2006;13:S56-S61.
3.
Altamar HO, Herrell SD: The current status of robot-assisted laparoscopic prostatectomy. Curr Opin Urol 2010;20:56-59.
4.
Cha EK, Lee DJ, Del Pizzo JJ: Current status of robotic partial nephrectomy (RPN). BJU Int 2011;108:935-941.
5.
Mottrie A, De Naeyer G, Novara G, Ficarra V: Robotic radical prostatectomy: a critical analysis of the impact on cancer control. Curr Opin Urol 2011;21:179-184.
6.
Shigemura K, Arakawa S, Yamashita M, Yasufuku T, Fujisawa M: Surgical site infections may be reduced by shorter duration of prophylactic antibiotic medication in urological surgeries. Jpn J Infect Dis 2009;62:440-443.
7.
Tollefson MK, Frank I, Gettman MT: Robotic-assisted radical prostatectomy decreases the incidence and morbidity of surgical site infections. Urology 2011;78:827-831.
8.
Matsumoto T, Kiyota H, Matsukawa M, Yasuda M, Arakawa S, Monden K; Japanese Society of UTI Cooperative Study Group (Chairman; Tetsuro Matsumoto): Japanese guidelines for prevention of perioperative infections in urological field. Int J Urol 2007;14:890-909.
9.
Hermsen ED, Hinze T, Sayles H, Sholtz L, Rupp ME: Incidence of surgical site infection associated with robotic surgery. Infect Control Hosp Epidemiol 2010;31:822-827.
10.
Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR: Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol 1999;20:250-278.
11.
Patel VR, Thaly R, Shah K: Robotic radical prostatectomy: outcomes of 500 cases. BJU Int 2007;99:1109-1112.
12.
Dasgupta P, Kirby RS: The current status of robot-assisted radical prostatectomy. Asian J Androl 2009;11:90-93.
13.
Froehner M, Koch R, Leike S, Novotny V, Twelker L, Wirth MP: Urinary tract-related quality of life after radical prostatectomy: open retropubic versus robot-assisted laparoscopic approach. Urol Int 2013;90:36-40.
14.
Gianino MM, Galzerano M, Martin B, Chiadò Piat S, Gontero P: Costs in surgical techniques for radical prostatectomy: a review of the current state. Urol Int 2012;88:1-5.
15.
Ficarra V, Novara G, Artibani W, Cestari A, Galfano A, Graefen M, Guazzoni G, Guillonneau B, Menon M, Montorsi F, Patel V, Rassweiler J, Van Poppel H: Retropubic, laparoscopic, and robot-assisted radical prostatectomy: a systematic review and cumulative analysis of comparative studies. Eur Urol 2009;55:1037-1063.
16.
Willis DL, Gonzalgo ML, Brotzman M, Feng Z, Trock B, Su LM: Comparison of outcomes between pure laparoscopic vs robot-assisted laparoscopic radical prostatectomy: a study of comparative effectiveness based upon validated quality of life outcomes. BJU Int 2012;109:898-905.
17.
Barnoiu OS, Baron Lopez F, Garcia Galisteo E, Soler Martinez J, Vozmediano Chicharro R, Del Rosal Samaniego JM, Machuca Santacruz J, Navarro Vilchez P, Sanchez Luque J, Bautista Vidal C, Gomez Lechuga P, Baena Gonzalez V: Comprehensive prediction model of urinary incontinence one year following robot-assisted radical prostatectomy. Urol Int 2013;90:31-35.
18.
Murphy DG, Kerger M, Crowe H, Peters JS, Costello AJ: Operative details and oncological and functional outcome of robotic-assisted laparoscopic radical prostatectomy: 400 cases with a minimum of 12 months follow-up. Eur Urol 2009;55:1358-1366.
19.
Tremp M, Sulser T, Seifert HH: Delayed infection of a pelvic lymphocele following robotic radical prostatectomy and pelvic lymphadenectomy: two cases. Urol Int 2009;83:479-481.
20.
Tsao AK, Smaldone MD, Averch TD, Jackman SV: Robot-assisted laparoscopic prostatectomy: the first 100 patients - improving patient safety and outcomes. J Endourol 2009;23:481-484.
21.
Fracalanza S, Ficarra V, Cavalleri S, Galfano A, Novara G, Mangano A, Artibani W: Is robotically assisted laparoscopic radical prostatectomy less invasive than retropubic radical prostatectomy? Results from a prospective, unrandomized, comparative study. BJU Int 2008;101:1145-1149.
22.
Khaira HS, Bruyere F, O'Malley PJ, Peters JS, Costello AJ: Does obesity influence the operative course or complications of robot-assisted laparoscopic prostatectomy. BJU Int 2006;98:1275-1278.
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