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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">nmp</journal-id><journal-title-group><journal-title xml:lang="ru">Журнал им. Н.В. Склифосовского «Неотложная медицинская помощь»</journal-title><trans-title-group xml:lang="en"><trans-title>Russian Sklifosovsky Journal "Emergency Medical Care"</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2223-9022</issn><issn pub-type="epub">2541-8017</issn><publisher><publisher-name>“N.V. Sklifosovsky Research Institute for Emergency Medicine”</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.23934/2223-9022-2024-13-4-748-755</article-id><article-id custom-type="elpub" pub-id-type="custom">nmp-2020</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>КЛИНИЧЕСКИЕ НАБЛЮДЕНИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>CLINICAL OBSERVATIONS</subject></subj-group></article-categories><title-group><article-title>Комбинированное лечение местно-распространенного кардиоэзофагеального рака у коморбидной пациентки со стенозом внутренней сонной артерии</article-title><trans-title-group xml:lang="en"><trans-title>Combined Treatment for Locally Advanced Cardioesophageal Cancer in a Comorbid Patient with Internal Carotid Artery Stenosis</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5194-5416</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Домрачев</surname><given-names>С. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Domrachev</surname><given-names>S. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Домрачев Сергей Анатольевич - профессор, доктор медицинских наук, профессор кафедры факультетской хирургии № 2 лечебного факультета ФГБОУ ВО «Российский университет медицины» МЗ РФ; ведущий научный сотрудник ГБУЗ «МКНПЦ им. А.С. Логинова» ДЗМ.</p><p>111123, Москва, ул. Новогиреевская, д. 1, корп. 1; 127006, Москва, ул. Долгоруковская, д. 4</p></bio><bio xml:lang="en"><p>Sergey A. Domrachev - Doctor of Medical Sciences, Full Professor, Department of Faculty Surgery No. 2, Medical Faculty, Russian University of Medicine; Leading Researcher, A.S. Loginov MCSC.</p><p>Novogireevskaya Str. 1, bldg. 1, Moscow, 111123; Dolgorukovskaya Str. 4, Moscow, 127006</p></bio><email xlink:type="simple">domra53@list.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4518-9874</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Лукьянчиков</surname><given-names>В. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Lukyanchikov</surname><given-names>V. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Лукьянчиков Виктор Александрович - доктор медицинских наук, профессор кафедры фундаментальной нейрохирургии ФДПО ФГАОУ ВО «РНИМУ им. Н.И. Пирогова» МЗ РФ (Пироговский Университет); научный сотрудник отдела неотложной нейрохирургии ГБУЗ «НИИ СП им. Н.В. Склифосовского ДЗМ»; ведущий научный сотрудник ФГБНУ «Научный центр неврологии».</p><p>117997, Москва, ул. Островитянова, д. 1; 129090, Москва, Большая Сухаревская пл., 3; 125367, Москва, Волоколамское шоссе, д. 80</p></bio><bio xml:lang="en"><p>Victor A. Lukyanchikov - Doctor of Medical Sciences, Professor, Department of Fundamental Neurosurgery, Faculty of Continuing Professional Education, Pirogov RNRMU; Researcher, Department of Emergency Neurosurgery, N.V. Sklifosovsky RIEM; Leading Researcher, Research Center of Neurology.</p><p>Ostrovitianov Str. 1, Moscow, 117997; Bolshaya Sukharevskaya Sq. 3, Moscow, 129090; Volokolamskoe shosse 80, Moscow, 125367</p></bio><email xlink:type="simple">vik-luk@yandex.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5543-199X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Семенов</surname><given-names>Н. Е.</given-names></name><name name-style="western" xml:lang="en"><surname>Semenov</surname><given-names>N. E.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Семенов Николай Евгеньевич - кандидат медицинских наук, врач-хирург отделения высокотехнологичной хирургии и хирургической эндоскопии ГБУЗ «МКНПЦ им. А.С. Логинова» ДЗМ.</p><p>111123, Москва, ул. Новогиреевская, д. 1, корп. 1</p></bio><bio xml:lang="en"><p>Nikolay E. Semenov - Candidate of Medical Sciences, Surgeon, Department of High-Tech Surgery and Surgical Endoscopy.</p><p>Novogireevskaya Str. 1, bldg. 1, Moscow, 111123</p></bio><email xlink:type="simple">semenov.ifmsa@gmail.com</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2864-9675</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шатохин</surname><given-names>Т. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Shatokhin</surname><given-names>T. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Шатохин тарас Андреевич - кандидат медицинских наук, доцент кафедры фундаментальной нейрохирургии ФДПО ФГАОУ ВО «РНИМУ им. Н.И. Пирогова» (Пироговский Университет) МЗ РФ; научный сотрудник отдела неотложной нейрохирургии ГБУЗ «НИИ СП им. Н.В. Склифосовского ДЗМ»; заведующий 2-м нейрохирургическим отделением ФГБНУ «Научный центр неврологии».117997, Москва, ул. Островитянова, д. 1; 129090, Москва, Большая Сухаревская пл., 3; 125367, Москва, Волоколамское шоссе, д. 80</p></bio><bio xml:lang="en"><p>Taras A. Shatokhin - Candidate of Medical Sciences, Associate Professor, Department of Fundamental Neurosurgery, Faculty of Continuing Professional Education, Pirogov RNRMU; Researcher, Department of Emergency Neurosurgery, N.V. Sklifosovsky RIEM; Head of the Neurosurgical Department No. 2, Research Center of Neurology.</p><p>Ostrovitianov Str. 1, Moscow, 117997; Bolshaya Sukharevskaya Sq. 3, Moscow, 129090; Volokolamskoe shosse 80, Moscow, 125367</p></bio><email xlink:type="simple">xshatokhinx@mail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-1804-9836</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Богданова</surname><given-names>О. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Bogdanova</surname><given-names>O. Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Богданова Олеся Юрьевна - кандидат медицинских наук, научный сотрудник отдела неотложной нейрохирургии ГБУЗ «НИИ СП им. Н.В. Склифосовского ДЗМ»; врач нейрохирург 2-го нейрохирургического отделения ФГБНУ «Научный центр неврологии»; врач-нейрохирург отделения ринонейрохирургии ФГБУ НМИЦО ФМБА России.</p><p>129090, Москва, Большая Сухаревская пл., 3; 125367, Москва, Волоколамское шоссе, д. 80; 123182, Москва, Волоколамское шоссе, д. 30, к. 2</p></bio><bio xml:lang="en"><p>Olesya Yu. Bogdanova - Candidate of Medical Sciences, Researcher, Department of Emergency Neurosurgery, N.V. Sklifosovsky RIEM; Neurosurgeon, Neurosurgical Department No. 2, Research Center of Neurology; Neurosurgeon, Department of Rhinoneurosurgery, National Medical Research Center for Otorhinolaryngology of the Federal MedicoBiological Agency of Russia.</p><p>Bolshaya Sukharevskaya Sq. 3, Moscow, 129090; Volokolamskoe shosse 80, Moscow, 125367; Volokolamskoe shosse 30, bldg. 2, Moscow, 123182</p></bio><email xlink:type="simple">ansher-iork1@yandex.ru</email><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0009-4955-0234</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кулов</surname><given-names>З. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Kulov</surname><given-names>Z. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Кулов Заурбек Аланович - врач нейрохирург 2-го нейрохирургического отделения ФГБНУ «Научный центр неврологии».</p><p>129090, Москва, Большая Сухаревская пл., 3</p></bio><bio xml:lang="en"><p>Zaurbek A. Kulov - Neurosurgeon, Neurosurgical Department No.2.</p><p>Volokolamskoe shosse 80, Moscow, 125367</p></bio><email xlink:type="simple">kulovza@mail.ru</email><xref ref-type="aff" rid="aff-5"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru">ГБУЗ «Московский клинический научный центр имени А.С. Логинова ДЗМ»; ФГБОУ ВО «Российский университет медицины» МЗ РФ<country>Россия</country></aff><aff xml:lang="en">A.S. Loginov Moscow Clinical Scientific Center; Russian University of Medicine<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru">ФГАОУ ВО «Российский национальный медицинский исследовательский университет имени Н.И. Пирогова» МЗ РФ; ГБУЗ «Научно-исследовательский институт скорой помощи им. Н.В. Склифосовского ДЗМ»; ФГБНУ «Научный центр неврологии»<country>Россия</country></aff><aff xml:lang="en">Pirogov Russian National Research Medical University; N.V. Sklifosovsky Research Institute for Emergency Medicine; Research Center of Neurology<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru">ГБУЗ «Московский клинический научный центр имени А.С. Логинова ДЗМ»<country>Россия</country></aff><aff xml:lang="en">A.S. Loginov Moscow Clinical Scientific Center<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru">ГБУЗ «Научно-исследовательский институт скорой помощи им. Н.В. Склифосовского ДЗМ»; ФГБНУ «Научный центр неврологии»; ФГБУ «Национальный медицинский исследовательский центр оториноларингологии Федерального медико-биологического агентства»<country>Россия</country></aff><aff xml:lang="en">N.V. Sklifosovsky Research Institute for Emergency Medicine; Research Center of Neurology; National Medical Research Center for Otorhinolaryngology of the Federal Medico-Biological Agency of Russia<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-5"><aff xml:lang="ru">ГБУЗ «Научно-исследовательский институт скорой помощи им. Н.В. Склифосовского ДЗМ»<country>Россия</country></aff><aff xml:lang="en">Research Center of Neurology<country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2024</year></pub-date><pub-date pub-type="epub"><day>29</day><month>01</month><year>2025</year></pub-date><volume>13</volume><issue>4</issue><fpage>748</fpage><lpage>755</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Домрачев С.А., Лукьянчиков В.А., Семенов Н.Е., Шатохин Т.А., Богданова О.Ю., Кулов З.А., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Домрачев С.А., Лукьянчиков В.А., Семенов Н.Е., Шатохин Т.А., Богданова О.Ю., Кулов З.А.</copyright-holder><copyright-holder xml:lang="en">Domrachev S.A., Lukyanchikov V.A., Semenov N.E., Shatokhin T.A., Bogdanova O.Y., Kulov Z.A.</copyright-holder><license license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.jnmp.ru/jour/article/view/2020">https://www.jnmp.ru/jour/article/view/2020</self-uri><abstract><p>ЦЕЛЬ ИССЛЕДОВАНИЯ    Представить случай комбинированного поэтапного хирургического лечения местно-распространенного кардиоэзофагеального рака, осложненного стенозом пищевода, у коморбидной пациентки со значительным поражением внутренней сонной артерии (ВСА) и обобщить данные научной литературы о методах ее диагностики и лечения.</p><p>МАТЕРИАЛ И МЕТОДЫ       Пациентка 65 лет, обратилась в МКНЦ в августе 2020 года с жалобами на затруднение прохождения плотной пищи по пищеводу. При обследовании в МКНЦ диагностирован рак кардиоэзофагеального перехода Siewert II cType 3 T4bN2M0 G3. Учитывая Результаты комплексной диагностики, у пациентки выявлен асимптомный стеноз ВСА до 75%. Выполнено поэтапное хирургическое лечение пациентки.</p><p>ОБСУЖДЕНИЕ          В приведенном клиническом наблюдении для профилактики развития интраи послеоперационных ишемических осложнений первым этапом пациентке выполнена каротидная эндартерэктомия с последующим хирургическим лечением основной патологии. Представленное наблюдение вызывает интерес из-за редкой встречаемости подобного сочетания оперативных вмешательств и отсутствия единого мнения, касаемого тактики лечения данной категории пациентов.</p><p>ЗАКЛЮЧЕНИЕ           Комбинированное этапное лечение пациентки с кардиоэзофагеальным раком и стенозом внутренней сонной артерии позволяет снизить риски периоперационных осложнений и улучшить прогнозы дальнейшего лечения основного заболевания.</p></abstract><trans-abstract xml:lang="en"><p>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.</p><p>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.</p><p>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.</p><p>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.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>кардиоэзофагеальный рак</kwd><kwd>стеноз внутренней сонной артерии</kwd><kwd>каротидная эндартерэктомия</kwd></kwd-group><kwd-group xml:lang="en"><kwd>cardioesophageal cancer</kwd><kwd>internal carotid artery stenosis</kwd><kwd>carotid endarterectomy</kwd></kwd-group><funding-group xml:lang="ru"><funding-statement>Исследование не имеет спонсорской поддержки</funding-statement></funding-group><funding-group xml:lang="en"><funding-statement>The study has no sponsorship</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Miccio JA, Oladeru OT, Yang J, Xue Y, Choi M, Zhang Y, et al. 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