1172 ANTIBIOTIC PROPHYLAXIS IS NOT NECESSARY IN MINIMALLY INVASIVE SURGERY FOR RENAL AND ADRENAL TUMORS: A PROSPECTIVE STUDY OF 301 CONSECUTIVE PATIENTS

Abstract

You have accessJournal of UrologyInfections/Inflammation of the Genitourinary Tract: Kidney & Bladder1 Apr 20111172 ANTIBIOTIC PROPHYLAXIS IS NOT NECESSARY IN MINIMALLY INVASIVE SURGERY FOR RENAL AND ADRENAL TUMORS: A PROSPECTIVE STUDY OF 301 CONSECUTIVE PATIENTS Toshiki Kijima, Soichiro Yoshida, Manabu Tatokoro, Saori Araki, Minato Yokoyama, Noboru Numao, Yohei Okada, Kazutaka Saito, Fumitaka Koga, Hitoshi Masuda, Yasuhisa Fujii, and Kazunori Kihara Toshiki KijimaToshiki Kijima Tokyo, Japan More articles by this author , Soichiro YoshidaSoichiro Yoshida Tokyo, Japan More articles by this author , Manabu TatokoroManabu Tatokoro Tokyo, Japan More articles by this author , Saori ArakiSaori Araki Tokyo, Japan More articles by this author , Minato YokoyamaMinato Yokoyama Tokyo, Japan More articles by this author , Noboru NumaoNoboru Numao Tokyo, Japan More articles by this author , Yohei OkadaYohei Okada Tokyo, Japan More articles by this author , Kazutaka SaitoKazutaka Saito Tokyo, Japan More articles by this author , Fumitaka KogaFumitaka Koga Tokyo, Japan More articles by this author , Hitoshi MasudaHitoshi Masuda Tokyo, Japan More articles by this author , Yasuhisa FujiiYasuhisa Fujii Tokyo, Japan More articles by this author , and Kazunori KiharaKazunori Kihara Tokyo, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.784AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES In AUA guideline, standard use of antibiotic prophylaxis is not recommended in open or laparoscopic surgery without entering urinary tract, except for patients with risk factors. This recommendation appears to be based on a general consensus in the field of abdominal surgery, however, and limited evidence is available in the field of urology. Gasless single port surgery has several features that may help reduce the incidence of infectious complications: a minimal incision, wound protection provided by the Alexis® wound retractor and completion of procedures without the insertion of fingers. In this study, we prospectively evaluated the incidences of surgical site infection (SSI) or other types of infection after gasless single port surgery for renal and adrenal tumors in the absence of antibiotic prophylaxis. METHODS We investigated 336 consecutive patients who underwent gasless single port total nephrectomy (n=171), partial nephrectomy (n=84) and adrenalectomy (n=81) between 2005 and 2010. Exclusion criteria were co-existing infection, uncontrolled diabetes mellitus, impaired immune responsiveness and opening of urinary tract during surgery. Patients who met these criteria were given a short course of second-generation cephalosporins. Perioperative infections were categorized into superficial SSI, deep SSI and other types of infection as defined by the US Centers for Disease Control and Prevention (CDC). Antibiotics were administered immediately upon diagnosis of perioperative infection. RESULTS Thirty-five (10%) of the 336 patients were excluded; the remaining 301 patients underwent radical nephrectomy (n=161), partial nephrectomy (n=73), or adrenalectomy (n=67) without antibiotic prophylaxis. There was no significant difference between these 3 groups in perioperative variables, including age, body mass index (BMI), American Society of Anesthesiologists (ASA) classification, length of operation, blood loss and National Nosocomial Infections Surveillance (NNIS) risk index. Incidences of superficial SSI, deep SSI and other types of infection in these 301 patients were 1.3%, 0.7%, and 3.0%, respectively; the differences of these values among 3 groups are not significant. All perioperative infections were successfully treated with additional antibiotics. CONCLUSIONS Antibiotic prophylaxis is not necessary in minimally invasive surgery for renal and adrenal tumors. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e470-e471 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Toshiki Kijima Tokyo, Japan More articles by this author Soichiro Yoshida Tokyo, Japan More articles by this author Manabu Tatokoro Tokyo, Japan More articles by this author Saori Araki Tokyo, Japan More articles by this author Minato Yokoyama Tokyo, Japan More articles by this author Noboru Numao Tokyo, Japan More articles by this author Yohei Okada Tokyo, Japan More articles by this author Kazutaka Saito Tokyo, Japan More articles by this author Fumitaka Koga Tokyo, Japan More articles by this author Hitoshi Masuda Tokyo, Japan More articles by this author Yasuhisa Fujii Tokyo, Japan More articles by this author Kazunori Kihara Tokyo, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...