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Updated: Aug 5, 2026
Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
Published on: February 12, 2022
Application of a Domestic Chinese Robotic Surgical System in Radical Resection Combined With Lateral Lymph Node
Feng Zheng1, Aihe Sun1, Peng Zhai1
1Department of General Surgery, The Fifth People's Hospital of Huai'an (Huai'an Hospital Affiliated to Yangzhou University), Huai'an, PR China.
Introduction:
Lateral lymph node dissection (LLND) in low rectal cancer is technically demanding due to the narrow pelvis and risk of nerve injury. Robotic surgery may improve visualization and precision, but evidence on domestic Chinese robotic systems for this procedure is limited. This study compared the safety and short-term outcomes of the KangDuo Surgical Robot-01 (KD-SR-01) robotic system with conventional laparoscopic surgery in patients undergoing radical resection with LLND.
Patients And Methods:
This retrospective single-center study included 278 patients with low rectal cancer who underwent radical resection plus LLND from June 2022 to June 2025. Patients were divided into robotic (n = 120, KangDuo KD-SR-01) and laparoscopic (n = 158) groups. Perioperative, pathological, postoperative, and short-term oncological outcomes were compared.
Results:
Baseline characteristics were comparable between groups. After 1:1 propensity score matching (119 pairs), the robotic group showed significantly shorter total operation time (238.7 ± 45.9 vs. 304.1 ± 58.9 minutes, P < .001), shorter LLND time (86.5 ± 23.2 vs. 121.1 ± 27.2 minutes, P < .001), lower blood loss (134.5 ± 52.3 vs. 351.8 ± 183.2 mL, P < .001), and higher lateral lymph node yield (7.87 ± 2.19 vs. 5.87 ± 2.34, P < .001) compared with the laparoscopic group. These advantages persisted in the matched cohort. Robotic surgery was also associated with, borderline lower overall complication rate (P = .047), and nominally lower sexual dysfunction (P = .047). Pathological outcomes and DFS (log-rank P = .163) were comparable.
Conclusion:
The domestic KangDuo KD-SR-01 robotic system is safe and feasible for radical resection with LLND in low rectal cancer. It provides significant perioperative and functional benefits compared to laparoscopy without compromising short-term oncological results.
