Simultaneous Surgery for Complicated Locally Advanced Gastric Cancer in a Patient during the Acute Phase of Ischemic Stroke

Relevance. In modern surgical practice, simultaneous operations are becoming increasingly relevant, especially in complex clinical scenarios such as complicated locally advanced gastric cancer in combination with acute ischemic stroke. To this day, the optimal timing and surgical approach remain the subject of discussion due to the high risks of mortality and disability. Aim. The aim is to improve patient outcomes, reduce surgical trauma, and enhance the quality of medical care – making this direction a key focus for modern surgery and oncology. On a broader scale, this work’s mission is to provide results that could serve as a foundation for international guidelines, helping to reduce mortality and improve patients’ quality of life. Case Description. We present a clinical case of a 69-year-old male patient diagnosed with ischemic stroke in the left carotid artery territory, atherothrombotic subtype. The patient had 65% stenosis of the left internal carotid artery with signs of plaque instability, and 45% stenosis on the right. He was also diagnosed with cancer of the gastric body and cardia (cT4N0M0), complicated by tumor breakdown and gastric bleeding. A multidisciplinary medical board concluded that a simultaneous operation was the most optimal and the only tactically justified approach in this situation. Conclusion. The topic of simultaneous surgery for locally advanced complicated gastric cancer during the acute phase of ischemic stroke is extremely original and highly relevant due to the increasing number of patients with comorbid conditions and the need for integrated surgical solutions. This clinical case may serve as a model for building an optimal surgical strategy for similar patient groups.