Gastrointestinal surgery: staging laparoscopy in gastric cancer: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Gastrointestinal surgery: staging laparoscopy in gastric cancer

Sample item

A 60-year-old man has biopsy-proven gastric adenocarcinoma. CT shows a resectable-looking antral tumour with no obvious distant disease, but the radiologist notes a small amount of free pelvic fluid. What is the best step before committing to gastrectomy?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Staging laparoscopy with peritoneal washings

CT can miss small peritoneal and liver surface deposits, and free fluid raises the suspicion. Staging laparoscopy with cytology avoids a non-therapeutic laparotomy in occult metastatic disease.

Option by option

  • A. Repeat upper endoscopy

    Repeat endoscopy adds no information on peritoneal spread.

  • B. Immediate open total gastrectomy

    Open surgery risks a futile laparotomy if peritoneal metastases are present.

  • C. Observation and repeat CT in three months

    Delay allows progression of a resectable cancer.

  • D. Staging laparoscopy with peritoneal washings (correct)

    Correct. Laparoscopy detects small peritoneal disease that CT misses.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More General Surgery questions

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is D, Staging laparoscopy with peritoneal washings. CT can miss small peritoneal and liver surface deposits, and free fluid raises the suspicion.

Why is "Repeat upper endoscopy" not the answer?

Repeat endoscopy adds no information on peritoneal spread.

Why is "Immediate open total gastrectomy" not the answer?

Open surgery risks a futile laparotomy if peritoneal metastases are present.

Why is "Observation and repeat CT in three months" not the answer?

Delay allows progression of a resectable cancer.

What concept does this question test?

It tests Gastrointestinal surgery: staging laparoscopy in gastric cancer in General Surgery. Staging laparoscopy with cytology avoids a non-therapeutic laparotomy in occult metastatic disease.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Gastrointestinal surgery: staging laparoscopy in gastric cancer?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.