FIELD: medicine.
SUBSTANCE: parietal layer of the abdominal membrane is dissected in the region of the root of the mesosigmoid. Hypogastric plexus are separated from the mesosigmoid. The parietal layer of the abdominal membrane is dissected in the region of the upper bound of lymphadenectomy. Cellular tissue in front of the aorta, near the orifice of the inferior mesenteric artery to the origin of the last sigmoid artery is removed. All sigmoid arteries are transected while retaining the left colic and superior rectal artery. The sigmoid colon is mobilised and transected. Sigmoid anastomosis is formed. With the aim of removing malignant tumour in the middle third of the sigmoid colon, the sigmoid colon is mobilised. Paraaortal lymphadenectomy is done. The body of the inferior mesenteric artery is skeletonised from its origin from the aorta to the level of origin of the last sigmoid artery. All sigmoid arties are transected from their origin from the inferior mesenteric artery while retaining the left colic and superior rectal artery. The resected part of the sigmoid colon together with the mesentery and lymph nodes from level N1 to level N3 are removed as a single unit. Sigmoid anastomosis is formed between healthy sections of the sigmoid colon.
EFFECT: reduced injuries of the procedure, prevention of development of local recurrence of diseases with lymphogenic character without lowering quality of life of patients due to reduction of boundaries for resection of the colon and Paraaortal lymphadenectomy.
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