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Ambulante und tageschirurgische Eingriffe

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Zusammenfassung

Das ambulante Operieren bringt neben finanzieller Entlastung der Kostenträger zweifelsohne eine Reihe von Vorteilen, aber auch Nachteile für die Patienten mit sich. Neben intensiven Anstrengungen zur Qualitätssicherung muss insbesondere die Diskussion über die Auswahl geeigneter Patienten für geeignete Eingriffe intensiv und kontinuierlich geführt werden. Dem Trend, das Spektrum ambulant durchgeführter Eingriffe auf ein immer stärker risikotragendes Patientengut auszudehnen, muss insgesamt zunächst mit Skepsis begegnet werden. Auch wenn mit den Fortschritten der Operationstechniken das operative Zugangstrauma erheblich reduziert werden kann und moderne Anästhesieverfahren eine sehr gute Steuerung der Patienten erlauben, stellt die Beherrschung der Komplikationen und Probleme der postoperativen Phase umso mehr besondere Herausforderungen sowohl an die ambulant operierenden Ärzte, Anästhesisten und Chirurgen als auch an die Patienten und mitbetreuenden Angehörigen.

Abstract

Ambulatory surgical care is intended to save healthcare expenditure from the economical viewpoint. From the patients point of view significant advantages as well as specific disadvantages of ambulatory surgery are known. The increase in the volume and complexity of procedures provided in an ambulatory setting are driven by improvements in anesthesia and surgical technique as well as by changes in financing and reimbursement. Therefore careful quality control and scientific evidence for the safety of increasingly used complex surgical procedures for higher risk patients is essential. Reducing the surgical trauma by minimally invasive surgical techniques and very good controllability by modern anesthesia concepts is making the management of the postoperative period crucial for successful ambulatory surgery. Most of the complications and common problems during the postoperative period, such as pain, nausea and vomiting, are not specific for ambulatory surgery, but management places an increasing burden of responsibility not only on general and specialised physicians, but also on other health professionals, patients, and family members.

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  1. Klinik für Anästhesiologie, Klinikum der Johannes Gutenberg-Universität, Mainz

    M. K. Schäfer & E. Wittenmeier

  2. Klinik für Anästhesiologie, Klinikum der Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz

    M. K. Schäfer

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Schäfer, M.K., Wittenmeier, E. Ambulante und tageschirurgische Eingriffe. Anaesthesist 52, 1046–1054 (2003). https://doi.org/10.1007/s00101-003-0595-7

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