Journal of Surgery
Review Article
Surgery without Sufficient Indications: an Update from Russia
Jargin SV*
Department of Pathology, People’s Friendship University of Russia,
Russian Federation
*Address for Correspondence:
Jargin SV, Department of Pathology, People’s Friendship University of Russia,
Clementovski per 6-82, 115184 Moscow, Russia, Tel: 7 4959516788; Email:
sjargin@mail.ru
Submission: 11 July, 2022
Accepted: 09 August, 2022
Published: 13 August, 2022
Copyright: © 2022 Jargin SV. This is an open access article distributed
under the Creative Commons Attribution License, which permits unrestricted
use, distribution, and reproduction in any medium, provided the original
work is properly cited.
Abstract
This review is an update and continuation of preceding papers
on invasive procedures applied in Russia with questionable clinical
indications. Certain methods have been applied according to
instructions by healthcare authorities and publication of leading
specialists, facilitated by lacking professional autonomy. Examples
are discussed here and in preceding papers: the overuse of Halsted
and Patey mastectomy, preventive electrocoagulation of cervical
ectropions without cytotological examination, gastrectomy for
peptic ulcers, thoracic and abdominal surgery for bronchial asthma
and diabetes mellitus, overuse of surgery in tuberculosis and other
pulmonary conditions, overuse of bronchoscopy e.g. in conscripts
with supposed pneumonia. Among mechanisms contributing to
the persistence of suboptimal methods has been the autocratic or
military managerial style discouraging criticism and polemics. Other
attributes of this style are the paternalistic approach to patients and
insufficient adherence to the principle of informed consent. Some
invasive procedures with questionable indications were advocated by
first generation military surgeons. Personnel training could have been
one of the motives. Note that military and medical ethics are not the
same. The comparatively short life expectancy in Russia is a strategic
advantage as it necessitates less healthcare investments and pensions.
Actually, Russia needs foreign help in the matter of healthcare. In
view of the current international tensions, the cooperation has been
partly interrupted. Obstacles to the import of medical products have
adverse consequences. Under these circumstances, the purpose of
this article was to remind that, performing a surgical or another invasive
procedure, the risk-to-benefit ratio must be kept as low as possible.
Insufficient coordination of medical studies and partial isolation from
the international scientific community can result in parallelism in
research, unnecessary experimentation, and application of invasive
methods without sufficient indications.