Some myths and misconceptions about abdominal surgery
https://doi.org/10.18705/3034-7270-2025-1-4-15-27
Abstract
In surgery, there are certain beliefs that have been passed down from generation to generation, from mentor to student, and have become deeply ingrained in practice, often existing outside the realm of rigorous clinical research. Over the past few decades, surgery has been plagued by numerous myths that have little to do with evidence-based medicine, but have become widely accepted as fact. However, in the 21st century, blindly following these myths without critical examination is not only unjustified but also potentially dangerous. In this article, we have examined several established myths in surgery from the perspective of current scientific data, in order to separate scientifically sound practices from established but outdated beliefs. This article is not an attempt to undermine authority or question the expertise of our great predecessors, but rather an attempt to engage in an honest and constructive dialogue for the sake of the ultimate goal of patient well-being.
About the Authors
B. V. SiguaRussian Federation
Sigua Badri V. – Doctor of Medical Sciences, Professor, Head of the Department of General Surgery
St. Petersburg
S. V. Kleimuk
Russian Federation
Kleimuk Sofya V. – Assistant of the Department of General Surgery
St. Petersburg
I. A. Solovyov
Russian Federation
Solovyov Ivan A. – Doctor of Medical Sciences, Professor, Deputy Chief Physician for Surgery
St. Petersburg
A. B. Singaevsky
Russian Federation
Singaevsky Andrey B. – Doctor of Medical Sciences, Professor, Professor of the Department of General Surgery
St. Petersburg
References
1. Zhang F, Tong L, Qiao H, et al. Taurine attenuates multiple organ injury induced by intestinal ischemia reperfusion in rats. J Surg Res. 2008;149(1):101–109. https://doi.org/10.1016/j.jss.2007.12.781.
2. Misiev DK, Malkov IS. Enteral insufficiency in the pathogenesis of acute intestinal obstruction and methods of its correction (literature review). Oncology Bulletin of the Volga region. 2022;13(1):61–66. (In Russ.).
3. Shapovalyants SG, Larichev SE, Shabrin AV, et al. Nasointestinal intubation in the treatment of acute adhesive small bowel obstruction. Pirogov Russian Journal of Surgery. 2022;12(12):81–89. https://doi.org/10.17116/hirurgia202212281. (In Russ.).
4. Miliukov VE, Sharifova KhM. Multiple organ manifestations of liver failure in acute small bowel obstruction. Pirogov Russian Journal of Surgery. 2019;(9):73–79. https://doi.org/10.17116/hirurgia201909173. (In Russ.).
5. Aliev SA, Aliev ES. Enteral insufficiency syndrome: current provisions about the terminology, pathogenesis and treatment (review of literature). Grekov's Bulletin of Surgery. 2020;179(6):101–106. https://doi.org/10.24884/0042-4625-2020-179-6-101-106. (In Russ.).
6. Scheltema G. Permeation in the examination and treatment of the stomach and intestines. Archives of the Roentgen ray. 1908;13(6):144–149.
7. Zemlyanoy VP, Sigua BV, Vovk AV, et al. Ebbott – Miller tube: intubate or not? Grekov's Bulletin of Surgery. 2017;176(4):100–103. https://doi.org/10.24884/0042-4625-2017-176-4-100-103. (In Russ.).
8. Clinical guidelines "Acute non-tumorous intestinal obstruction." All-Russian Public Organization "Russian Society of Surgeons." Moscow; 2021. 52 p. (In Russ.).
9. Ten Broek RPG, Krielen P, Di Saverio S, et al. Bologna guidelines for diagnosis and management of adhesive small bowel obstruction (ASBO): 2017 update of the evidencebased guidelines from the world society of emergency surgery ASBO working group. World J Emerg Surg. 2018;13(24):1–13. https://doi.org/10.1186/s13017-018-0185-2.
10. Demessence R, Lyoubi Y, Feuerstoss F, et al. Surgical management of adhesive small bowel obstruction: Is it still mandatory to wait? – An update. J Visc Surg. 2022;159(4):309–319. https://doi.org/10.1016/j.jviscsurg.2022.02.002.
11. Fleshner PR, Siegman MG, Slater GI, et al. A prospective, randomized trial of short versus long tubes in adhesive small-bowel obstruction. Am J Surg. 1995;170(4):366–370. https://doi.org/10.1016/s0002-9610(99)80305-5.
12. Aliev SA, Aliev ÉS. Nasointestinal intubation in surgery of acute intestinal obstruction and peritonitis: past, present and future. Pirogov Russian Journal of Surgery. 2021;(10):92–99. https://doi.org/10.17116/hirurgia202110192. (In Russ.).
13. Uzankichian AA, Asatrian AR, Zakarian AE, et al. Pathogenesis of enteral insufficiency in patients with postoperative peritonitis. Pirogov Russian Journal of Surgery. 2010;(11):42–47. (In Russ.).
14. Ermolov AS, Popova TS, Pahomova GE, et al. Sindrom kishechnoj nedostatochnosti v neotlozhnoj abdominal’noj khirurgii. Moscow: Medekspert, 2005, 460 p. (In Russ.).
15. Fazel MZ, Jamieson RW, Watson CJ. Long-term follow-up of the use of the Jones' intestinal tube in adhesive small bowel obstruction. Ann R Coll Surg Engl. 2009;91(1):50–54. https://doi.org/10.1308/003588409X358999.
16. Petrowsky H, Demartines N, Rousson V, et al. Evidencebased value of prophylactic drainage in gastrointestinal surgery: a systematic review and meta-analyses. Ann Surg. 2004;240(6):1074–1084. https://doi.org/10.1097/01.sla.0000146149.17411.
17. Urbach DR, Kennedy ED, Cohen MM. Colon and rectal anastomoses do not require routine drainage: a systematic review and meta-analysis. Ann Surg. 1999;229(2):174–180. https://doi.org/10.1097/00000658-199902000-00003.
18. Shevchenko YuL, Stoyko YuM, Zubritskiy VF, et al. Is abdominal drainage necessary in peritonitis? A new look at the old problem. Vestnik Natsional’nogo mediko-khirurgicheskogo tsentra im. N.I. Pirogova. 2012;7(3):11–14. (In Russ.).
19. Allemann P, Probst H, Demartines N, et al. Prevention of infectious complications after laparoscopic appendectomy for complicated acute appendicitis – the role of routine abdominal drainage. Langenbecks Arch Surg. 2011;396(1):63– 68. https://doi.org/10.1007/s00423-010-0709-z.
20. O'Connor TW, Hugh TB. Abdominal drainage: a clinical review. Aust N Z J Surg. 1979;49(2):253–260. https://doi.org/10.1111/j.1445-2197.1979.tb04951.x.
21. Schein M. To drain or not to drain? The role of drainage in the contaminated and infected abdomen: an international and personal perspective. World J Surg. 2008;32(2):312– 321. https://doi.org/10.1007/s00268-007-9277-y.
22. Sazhin AV, Gulyaev AA, Ermolov AS, et al. Acute appendicitis in adults. Pirogov Russian Journal of Surgery. 2024;(11):5–23. https://doi.org/10.17116/hirurgia20241115. (In Russ.).
23. Sopuev AA, Kalzhikeev AA, Myrzakalykov KI, et al. Modern views on abdominal drainage after appendicectomy. Bulletin of KSMU. 2023;1(1):86–88. https://doi.org/10.20861/2304-2338-2016-63-002. (In Russ.).
24. Wu H, Liao B, Cao T, et al. Advantages comparison of peritoneal drainage versus no drainage after laparoscopic appendectomy for complicated appendicitis: a meta-analysis. BMC Gastroenterol. 2024;24(1):411. https://doi.org/10.1186/s12876-024-03500-8.
25. Wang J, Liu L. Prophylactic antibiotics and abdominal drainage in early recovery pathway for hepatectomy. Hepatobiliary Surg Nutr. 2018;7(2):156–157. https://doi.org/10.21037/hbsn.2018.03.09.
26. He J, Qian G, Mao Y, et al. Comparison of early vs. routine removal of abdominal drainage tube after laparoscopic appendectomy for perforated appendicitis: a retrospective cohort study. Front Surg. 2025;12:1617312. https://doi.org/10.3389/fsurg.2025.1617312.
27. Zemlyanoy VP, Sigua BV, Filenko BP, et al. Once again on the issue of abdominal drainage. Grekov's Bulletin of Surgery. 2018;177(4):86–88. https://doi.org/10.24884/0042-4625-2018-177-4-86-88. (In Russ.).
28. Lewis RT, Goodall RG, Marien B, et al. Simple elective cholecystectomy: to drain or not. Am J Surg. 1990;159(2):241–245. https://doi.org/10.1016/s0002-9610(05)80271-5.
29. Nursal TZ, Yildirim S, Tarim A, et al. Effect of drainage on postoperative nausea, vomiting, and pain after laparoscopic cholecystectomy. Langenbecks Arch Surg. 2003;388(2):95–100. https://doi.org/10.1007/s00423-003-0374-6.
30. Jorgensen JO, Gillies RB, Hunt DR, et al. A simple and effective way to reduce postoperative pain after laparoscopic cholecystectomy. Aust N Z J Surg. 1995;65(7):466–469. https://doi.org/10.1111/j.1445-2197.1995.tb01787.x.
31. Cirocchi R, Kwan SH, Popivanov G, et al. Routine drain or no drain after laparoscopic cholecystectomy for acute cholecystitis. Surgeon. 2021;19(3):167–174. https://doi.org/10.1016/j.surge.2020.04.011.
32. Xu M, Tao YL. Drainage versus No Drainage after Laparoscopic Cholecystectomy for Acute Cholecystitis: A MetaAnalysis. Am Surg. 2019;85(1):86–91.
33. Picchio M, Lucarelli P, Di Filippo A, et al. Meta-analysis of drainage versus no drainage after laparoscopic cholecystectomy. JSLS. 2014;18(4):e2014.00242. https://doi.org/10.4293/JSLS.2014.00242.
34. Zubritskiy VF, Pokrovskiy KA, Zabelin MV, et al. Abdominal suction after abdominal surgeries. Rational view of the problem. Annals of Surgery. 2012;(1):67–70. (In Russ.).
35. Maskin SS, Alexandrov VV, Matyukhin VV, et al. Standardization of the medical and diagnostic approach in combined closed intestinal trauma. Polytrauma. 2020;(3):12–19. https://doi.org/10.24411/1819-1495-2020-10028. (In Russ.).
36. Korobka VL, Balin NI. A new method of colorectal anastomosis formation. Medical Bulletin of the North Caucasus. 2010;(2):4–7. (In Russ.).
37. Lebedko MS, Gordeev SS, Alieva EV, et al. Risk factors for colorectal anastomotic leakage and preventive measures: a retrospective cohort study. Pelvic Surgery and Oncology. 2022;12(2):17–27. https://doi.org/10.17650/2686-9594-2022-12-2-17-27. (In Russ.).
38. Nikolaeva AO, Danilov MA, Atroshchenko AO. Assessment of risk factors for development of incompetence of interintestinal anastomoses: literature review. Science of the young. 2020;8(1):106–115. https://doi.org/10.23888/HMJ202081106-115. (In Russ.).
39. Cherepenin MYu, Lutkov IV, Gorsky VA. Comparative analysis of hemorrhoid treatment by electrocoagulation, bipolar electrosection and combined laser destruction. Moscow Surgical Journal. 2023;(1):27–33. https://doi.org/10.17238/2072-3180-2023-1-27-33. (In Russ.).
40. Mykhaylicenko VYu, Drevetnyak AA, Gavrilenko S, et al. Modern methods of surgical treatment of anal fissures. Tauric medical-biological newsletter. 2018;21(4):47–52. (In Russ.).
41. Aliev S. A., Aliev E. S. Modern trends and priority in treatment of chronic anal fissure. Grekov’s Bulletin of Surgery. 2024;183(4):77–84. https://doi.org/10.24884/0042-4625-2024-183-4-77-84. (In Russ.).
42. Hareesh GSR, Somangurthy P. Comparative study of manual anal dilatation and lateral internal anal sphincterotomy in the treatment of acute anal fissure. Int. Surg. J. 2019;6(6):2022– 2027. https://doi.org/10.18203/2349-2902.isj20192359.
43. Yang Y, Shu Y, Su F, et al. Prophylactic transanal decompression tube versus non-prophylactic transanal decompression tube for anastomotic leakage prevention in low anterior resection for rectal cancer: a meta-analysis. Surg Endosc. 2017;31(4):1513–1523. https://doi.org/10.1007/s00464-016-5193-2.
44. Wang Z, Liang J, Chen J, et al. Effectiveness of a transanal drainage tube for the prevention of anastomotic leakage after laparoscopic low anterior resection for rectal cancer. Asian Pac J Cancer Prev. 2020;21(5):1441–1444. https://doi.org/10.31557/APJCP.2020.21.5.1441.
45. Adamova Z. Transanal tube as a means of prevention of anastomotic leakage after rectal cancer surgery. Viszeralmedizin. 2014;30(6):422–426. https://doi.org/10.1159/000369569.
46. Groshilin VS, Martynov DV, Naboka YuL, et al. Correction of dysbiosis in diversion proctitis: possibilities of intraluminal sanitation and the prevention of complications after reconstructive surgery. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2019;29(6):36– 48. https://doi.org/10.22416/1382-4376-2019-29-6-36-48. (In Russ.).
47. Wang S, Zhang Z, Liu M, et al. Efficacy of transanal tube placement after anterior resection for rectal cancer: a systematic review and meta-analysis. World J Surg Oncol. 2016(92):1–6. https://doi.org/10.1186/s12957-016-0854-0.
48. Salimgireeva BZh, Almabaev YA, Ermentaeva ZhM, et al. Formation of intestinal suture in the formation of intestinal anastomosis and the adequacy of the choice of type of intestinal suture. Problems of Science. 2018;(10):57–62. (In Russ.).
49. Kagan II, Abramzon OM, Makaev MI. Characteristics of esophageal-intestinal anastomoses in gastrectomy. Bulletin of experimental and clinical surgery. 2013;6(4):519–525. (In Russ.).
50. Shashkin DV. Possibilities of Interintestinal Anastomoses in Colorectal Surgery (Review). Orenburg Medical Bulletin. 2013;1(4):70–75. (In Russ.).
51. Kagan II, Tretyakov AA, Esipov VK. Principles and experimental-morphological substantiation of microsurgical intestinal suture. Orenburg Medical Bulletin. 2015;3(11):29–34. (In Russ.).
52. Semenyuta AA, Goldberg OA, Lepekhova SA, et al. Morphological features of intestinal anastomosis formation using various types of intestinal sutures in an experiment. Russian Bulletin of Pediatric Surgery, Anesthesiology, and Resuscitation. 2017;7(3):47–54. (In Russ.).
53. Shamatkova SV, Tikhonova LV. Microsurgical method of single-row continuous Z-shaped intestinal suture. Bulletin of experimental and clinical surgery. 2014;7(1):70–73. (In Russ.).
Review
For citations:
Sigua B.V., Kleimuk S.V., Solovyov I.A., Singaevsky A.B. Some myths and misconceptions about abdominal surgery. Russian surgical journal. 2025;1(4):15-27. (In Russ.) https://doi.org/10.18705/3034-7270-2025-1-4-15-27
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