Colorectal and anal surgery: recognition: 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 · Colorectal and anal surgery: recognition

Sample item

A surgeon operates for mid-rectal adenocarcinoma, using sharp dissection in the avascular embryological plane around the fascia propria and preserving the hypogastric nerves to lower local recurrence. Which principle is being applied?

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

The answer and the reasoning

A. Total mesorectal excision

Removing the rectum with its surrounding fatty and lymphatic mesorectum intact within its fascia reduces circumferential margin involvement and local recurrence. Preserving the autonomic nerves protects bladder and sexual function.

Option by option

  • A. Total mesorectal excision (correct)

    Correct. En bloc removal of the mesorectum in its fascial envelope is the standard for mid and low rectal cancer.

  • B. Right hemicolectomy

    Right hemicolectomy treats caecal and ascending colon lesions.

  • C. Transanal local excision

    Local excision is for selected early tumours and does not remove mesorectal nodes.

  • D. Hartmann procedure

    Hartmann procedure is resection with end colostomy, usually in emergencies.

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.

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Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is A, Total mesorectal excision. Removing the rectum with its surrounding fatty and lymphatic mesorectum intact within its fascia reduces circumferential margin involvement and local recurrence.

Why is "Right hemicolectomy" not the answer?

Right hemicolectomy treats caecal and ascending colon lesions.

Why is "Transanal local excision" not the answer?

Local excision is for selected early tumours and does not remove mesorectal nodes.

Why is "Hartmann procedure" not the answer?

Hartmann procedure is resection with end colostomy, usually in emergencies.

What concept does this question test?

It tests Colorectal and anal surgery: recognition in General Surgery. Preserving the autonomic nerves protects bladder and sexual function.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Colorectal and anal surgery: recognition?

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.