Combined Treatment for Locally Advanced Cardioesophageal Cancer in a Comorbid Patient with Internal Carotid Artery Stenosis

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Abstract
AIM OF THE STUDY was to present a case of combined, staged surgical treatment for locally advanced cardioesophageal cancer complicated by esophageal stenosis in a comorbid patient with a significant lesion of the internal carotid artery, and to summarize the data of scientific literature on the methods for its diagnosis and treatment.MATERIAL AND METHODS A 65-year-old patient came to the Moscow Clinical Research and Practice Center named after A.S. Loginov in August 2020 with complaints of difficulty in passing solid food through the esophagus. During the examination at the Center, Siewert II cType 3 T4bN2M0 G3 cardioesophageal junction cancer was diagnosed. Taking into account the results of comprehensive diagnostics, the patient was found to have asymptomatic stenosis of the internal carotid artery up to 75%. Step-by-step surgical treatment of the patient was performed.DISCUSSION In the presented clinical observation for prevention of intraand postoperative ischemic complications, at the first stage the patient underwent carotid endarterectomy followed by surgical treatment for the underlying pathology. The presented observation is of interest due to the rare occurrence of such a combination of surgical interventions and the lack of consensus regarding the treatment tactics for this category of patients.CONCLUSION Combined staged treatment of a patient with cardioesophageal cancer and internal carotid artery stenosis reduces the risk of perioperative complications and improves the prognosis of further treatment for the underlying disease.

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