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Comparison of right and left laparoscopic live donor nephrectomy
Author(s) -
Kay Mark D.,
Brook Nicholas,
Kaushik Monika,
Harper Simon J.F.,
Bagul Atul,
Nicholson Michael L.
Publication year - 2006
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2006.06429.x
Subject(s) - medicine , nephrectomy , surgery , renal vein , kidney , dissection (medical) , laparoscopy , renal function , inferior vena cava , urology
OBJECTIVE To compare the anatomy and function of right and left kidneys retrieved by laparoscopic live donor nephrectomy (LDN). PATIENTS AND METHODS In all, 84 transperitoneal LDNs were performed, 66 left and 18 right. Two different right‐sided LDN techniques were used: initially, the inferior vena cava (IVC) was controlled with a Satinsky clamp introduced through a 6–8 cm right upper quadrant incision, through which the kidney was also removed (six patients). Subsequently, the IVC was completely mobilized by laparoscopic retrocaval dissection (in 12 patients), allowing the use of a linear stapler‐cutter, including the caval ostium with the renal vein. The kidney was then removed through a short Pfannenstiel incision. RESULTS Left kidneys had longer renal veins (38 vs 27 mm; P < 0.05), but there were no differences in arterial length (32 vs 31 mm). Three right kidneys required back‐table renal vein lengthening. The operative duration was shorter for right‐sided LDNs (132 vs 182 min; P < 0.05). The serum creatinine level at 3 months was 131 vs 134 mmol/L for right and left kidneys, respectively. CONCLUSIONS Despite faster surgery suggesting that the right LDN is technically easier, there is a greater need for back‐table reconstruction of the renal vein. The functional results of right and left kidneys are equivalent.