The role of antimicrobial prophylaxis in laparoscopic nephrectomy for renal cell carcinoma

TL;DR

This study found that using antibiotics before laparoscopic kidney surgery for kidney cancer does not reduce postoperative infections.

Contribution

The study provides evidence that antimicrobial prophylaxis does not significantly affect infection rates after laparoscopic nephrectomy.

Findings

Antimicrobial prophylaxis did not reduce 30-day postoperative infection rates.

White blood cell count increase was lower in the prophylaxis group.

Hospital stay duration was similar between the two groups.

Abstract

To investigate the role of antimicrobial prophylaxis in laparoscopic nephrectomy for renal cell carcinoma.

We retrospectively enrolled 1000 patients who underwent laparoscopic nephrectomy from August 2019 to November 2021 in the Peking Union Medical College Hospital. Patients were divided into group without antimicrobial prophylaxis (n = 444) and group with antimicrobial prophylaxis (n = 556). Outcomes including 30-day postoperative infection rate, the increase rate of pre- and post-operative white blood cell counts and hospital stay were analyzed.

The overall infection rate was 5.0% (28/556) in the group with antimicrobial prophylaxis, which was similar to 4.1% (18/444) in the group without antimicrobial prophylaxis (P = 0.461). The increase rate of pre- and post-operative white blood cell counts was significantly lower (85.5% versus 97.0%) in the group with antimicrobial prophylaxis (P = 0.004). The postoperative hospital stay was 5 (4, 6) days in both groups (P = 0.483). Logistic regression analyses identified the use of antimicrobial prophylaxis had no influence on the occurrence of infection events (odds ratio = 0.797; 95% confidence interval, 0.435–1.460; P = 0.462). Hemoglobin (odds ratio = 0.430; 95% confidence interval, 0.257–0.719; P = 0.001) and partial nephrectomy (odds ratio = 2.292; 95% confidence interval, 1.724–3.046; P < 0.001) influenced the use of antimicrobial prophylaxis independently.

The use of antimicrobial prophylaxis had no impact on postoperative infection in patients receiving laparoscopic nephrectomy for renal cell carcinoma.

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