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  • Title: Comparison of right and left laparoscopic live donor nephrectomy.
    Author: Kay MD, Brook N, Kaushik M, Harper SJ, Bagul A, Nicholson ML.
    Journal: BJU Int; 2006 Oct; 98(4):843-4. PubMed ID: 16978281.
    Abstract:
    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.
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