Comparison of the transperitoneal and a semi-open retroperitoneal approach for right-sided laparoscopic donor nephrectomy.

Background: To investigate whether the retroperitoneal or transperitoneal approach is preferable for right-sided laparoscopic donor nephrectomy (R-LDN).

Material/methods: We retrospectively compared the donor and recipient outcomes of R-LDNs performed with a standard transperitoneal approach (n=21) or a semi-open retroperitoneal approach (n=32).

Results: Patient demographics were similar between groups. The semi-open retroperitoneal group had shorter operative time (89.5 min vs. 105 min, p<0.001), shorter WIT (102 s vs. 120 s, p<0.001), and longer renal veins (2.5 cm vs. 2.2 cm, p<0.001). No conversions to open procedures occurred. There were no significant differences in the blood loss, length of hospital stay, or donor complication rate between the 2 groups. All grafts functioned adequately, and there were no significant differences in graft function, first-week hemodialysis, and serum creatinine level at discharge between the 2 groups The recipient complication rate was similar between the 2 groups (9.4% vs. 9.5%, p=0.986).

Conclusions: The semi-open retroperitoneal approach is safe and effective for R-LDN. Further study is required to evaluate long-term graft function.