{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T22:41:42Z","timestamp":1792190502199,"version":"4.4.0"},"reference-count":5,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T00:00:00Z","timestamp":1767052800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T00:00:00Z","timestamp":1767052800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Asian J Endoscop Surgery"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Management of distal ureteral urothelial carcinoma remains challenging, with kidney\u2010sparing surgery (KSS) emerging as a viable alternative to radical nephroureterectomy in selected cases. We report our initial experience with robot\u2010assisted partial ureterectomy using the da Vinci Xi surgical system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Surgical Technique<\/jats:title>\n                    <jats:p>Between 2024 and 2025, five patients underwent robot\u2010assisted KSS for distal ureteral tumors. All procedures were performed using the da Vinci Xi system with a transperitoneal approach in lithotomy position. The surgical technique involved extensive proximal ureteral mobilization to the level just distal to the common iliac artery crossing, excision with adequate margins including bladder cuff, and neo\u2010ureterocystostomy to intact bladder mucosa using V\u2010Loc suture. Frozen section analysis of the proximal margin was performed with conversion to nephroureterectomy planned if positive. Written informed consent was obtained from all patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Median operative time was 205\u2009min (range: 174\u2013253) with median console time of 170\u2009min. Median estimated blood loss was 65\u2009mL (range: 5\u2013215\u2009mL). Pathological examination revealed urothelial carcinoma in all cases: two patients had pT3 disease and three had pTa disease. Surgical margins were negative in four cases and indeterminate in one. One patient (20%) experienced a Clavien\u2010Dindo Grade 2 complication. All patients maintained stable renal function. At a median follow\u2010up of 6\u2009months, no local recurrence or upper tract recurrence was observed. Robot\u2010assisted KSS with extensive proximal ureteral resection appears feasible and safe for selected patients with distal ureteral tumors. Longer follow\u2010up and larger series are needed to confirm oncological efficacy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ases.70228","type":"journal-article","created":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T03:00:26Z","timestamp":1767150026000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Robot\u2010Assisted Kidney\u2010Sparing Surgery for Distal Ureteral Urothelial Carcinoma: Initial Experience With Five Cases in Japan"],"prefix":"10.1111","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2300-8446","authenticated-orcid":false,"given":"Shugo","family":"Yajima","sequence":"first","affiliation":[{"name":"Department of Urology National Cancer Center Hospital East  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaku","family":"Okumura","sequence":"additional","affiliation":[{"name":"Department of Urology National Cancer Center Hospital East  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika","family":"Ikezoe","sequence":"additional","affiliation":[{"name":"Department of Urology National Cancer Center Hospital East  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu","family":"Goudu","sequence":"additional","affiliation":[{"name":"Department of Urology National Cancer Center Hospital East  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoki","family":"Imasato","sequence":"additional","affiliation":[{"name":"Department of Urology National Cancer Center Hospital East  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kohei","family":"Hirose","sequence":"additional","affiliation":[{"name":"Department of Urology National Cancer Center Hospital East  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madoka","family":"Kataoka","sequence":"additional","affiliation":[{"name":"Department of Urology National Cancer Center Hospital East  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasukazu","family":"Nakanishi","sequence":"additional","affiliation":[{"name":"Department of Urology National Cancer Center Hospital East  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitoshi","family":"Masuda","sequence":"additional","affiliation":[{"name":"Department of Urology National Cancer Center Hospital East  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,30]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2023.03.013"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-016-1819-1"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2012.11169.x"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2012.10960.x"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1089\/end.2007.0279"}],"container-title":["Asian Journal of Endoscopic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ases.70228","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ases.70228","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ases.70228","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T22:21:34Z","timestamp":1792189294000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ases.70228"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,30]]},"references-count":5,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1111\/ases.70228"],"URL":"https:\/\/doi.org\/10.1111\/ases.70228","archive":["Portico"],"relation":{},"ISSN":["1758-5902","1758-5910"],"issn-type":[{"value":"1758-5902","type":"print"},{"value":"1758-5910","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,30]]},"assertion":[{"value":"2025-10-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-22","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70228"}}