Robot‐Assisted Kidney‐Sparing Surgery for Distal Ureteral Urothelial Carcinoma: Initial Experience With Five Cases in Japan

Median operative time was 205 min (range: 174-253) with median console time of 170 min. Median estimated blood loss was 65 mL (range: 5-215 mL). 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-Dindo Grade 2 complication. All patients maintained stable renal function. At a median follow-up of 6 months, no local recurrence or upper tract recurrence was observed. Robot-assisted KSS with extensive proximal ureteral resection appears feasible and safe for selected patients with distal ureteral tumors. Longer follow-up and larger series are needed to confirm oncological efficacy.