Right versus left retroperitoneoscopic living-donor nephrectomy.

Area of Science:

• Urology
• Nephrology
• Minimally Invasive Surgery

Background:

• Retroperitoneoscopic donor nephrectomy (RDN) is a minimally invasive technique for kidney donation.
• Comparing outcomes between right and left-sided RDN is crucial for surgical planning and patient selection.

Purpose of the Study:

• To compare the safety and efficacy of right-side versus left-side retroperitoneoscopic donor nephrectomy (RDN) using a hybrid technique.

Main Methods:

• Retrospective review of 151 consecutive RDN patients (May 2005 - July 2013).
• Comparison of intraoperative parameters, postoperative donor outcomes, and recipient outcomes between right (n=87) and left (n=64) nephrectomy groups.

Main Results:

• No significant differences observed in donor blood loss, warm ischemia time, postoperative creatinine, hospital stay, recipient creatinine at 1 year, or 1-year graft survival.
• Right RDN demonstrated significantly shorter graft extraction time (152 vs. 168 min) and overall operative time (175 vs. 195 min) compared to left RDN (P < 0.059).
• One right RDN case required open conversion due to inferior vena cava bleeding.

Conclusions:

• Both right and left RDN, using the hybrid technique, can be performed with similar donor and recipient outcomes.
• Further studies with larger sample sizes are needed to fully evaluate postoperative complication rates.