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What is it about?

This review is an update and continuation of preceding publications on invasive procedures applied in Russia with questionable clinical indications. Recommendations are generally avoided here. Some newest Russian-language textbooks are based on the international literature thanks to the gratis Internet resources. However, earlier manuals contained recommendations partly at variance with accepted guidelines. Special attention is given here to bronchoscopy in asthma and tuberculosis. Several questionable methods are briefly discussed: laser therapy via bronchoscope in atrophic bronchitis and other conditions; endobronchial instillations of surfactant in adults, overuse of cystoscopy in connection with the overdiagnosis of malignant and premalignant urinary bladder lesions. The principle of informed consent was not sufficiently known and observed, being mentioned only in some recent papers. In conclusion, performing invasive procedures, the risk-benefit ratio should be kept as low as possible. Consent of human subjects for participation in research requires that they fully understand their role and risks, being able to withdraw any time without disadvantage. Children require additional protection. Training methods not involving patients, using anatomic models and video technologies, should be used.

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