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

Abstract Background: Antimicrobial prophylaxis (AMP) is a regular perioperative procedure to prevent postoperative infection. However, the role and standard regimen of AMP in laparoscopic urologic surgery remain controversial. Our study aimed to investigate the role of AMP in laparoscopic nephrectomy for renal cell carcinoma (RCC). Methods: 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 non-AMP (n = 444) group and AMP (n = 556) group. Outcomes including 30-day postoperative infection rate, the increase rate of pre- and post-operative white blood cell (WBC) counts and hospital stay were analyzed. Results: The overall infection rate was 5.0% (28/556) in the AMP group, which was similar to 4.1% (18/444) in the non-AMP group ( P = 0.461). The increase rate of pre- and post-operative WBC counts was significantly lower (85.5% versus 97.0%) in the AMP group ( 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 AMP had no influence on the occurrence of infection events [odds ratio (OR) = 0.797; 95% confidence interval (CI), 0.435–1.460; P = 0.462]. Hemoglobin (OR = 0.430; 95% CI, 0.257–0.719; P = 0.001) and partial nephrectomy (OR = 2.292; 95% CI, 1.724–3.046; P < 0.001) influenced the use of AMP independently. Conclusions: The use of AMP had no impact on postoperative infection in patients receiving laparoscopic nephrectomy for RCC.