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Laryngorhinootologie 2024; 103(11): 788-796
DOI: 10.1055/a-2353-2347
Leitlinien und Empfehlungen

Ambulante Durchführung rhinochirurgischer Operationen unter Berücksichtigung des Einsatzes von Nasentamponaden

Positionspapier der Deutschen Gesellschaft für HNO-Heilkunde, Kopf- und Halschirurgie, der Arbeitsgemeinschaft Rhinologie/Rhinochirurgie (ARHIN) der Deutschen Gesellschaft für HNO-Heilkunde, Kopf- und Halschirurgie und des Deutschen Berufsverbandes der HNO-ÄrzteSinunasal surgery as outpatient procedure with special consideration of nasal packingPosition paper of the German Society of Otorhinolaryngology, Head and Neck Surgery, the working group Rhinology/Rhinosurgery (ARHIN) of the German Society of Otorhinolaryngology, Head and Neck Surgery and German Professional Association of Otorhinolaryngologists
Rainer K. Weber
1   Klinik für Hals-, Nasen- und Ohrenheilkunde, Städtisches Klinikum Karlsruhe, Karlsruhe, Germany
2   Sinus Academy, Karlsruhe
,
Thomas Deitmer
3   Deutsche Gesellschaft für HNO-Heilkunde, Kopf- und Hals-Chirurgie e.V., Bonn, Deutschland
,
Jan Löhler 
4   Deutscher Berufsverband der HNO-Ärzte e.V., Neumünster
,
Christoph Aletsee
5   HNO-Praxis, Bad Kreuznach
,
Ingo Baumann
6   Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum, Heidelberg, Germany (Ringgold ID: RIN27178)
,
Christian Betz
7   Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany (Ringgold ID: RIN37734)
,
Achim Beule
8   Klinik für HNO-Heilkunde, Universitätsklinikum Münster, Münster
,
Robert Böscke
9   Klinik für Hals-Nasen-Ohren-Heilkunde, Medizinischer Campus der Carl-von-Ossietzky Universität Oldenburg, Evangelisches Krankenhaus Oldenburg, Oldenburg
,
Andreas Dietz
10   Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Universitatsklinikum Leipzig, Leipzig, Germany (Ringgold ID: RIN39066)
,
Vanessa Harnischmacher
11   Klinik für Hals-Nasen-Ohren-Heilkunde, Städtisches Klinikum, Karlsruhe
,
Frank Haubner
12   Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Klinikum der LMU München, München, Germany
,
Werner Heppt
13   Klinik für Hals-Nasen-Ohren-Heilkunde, Städtisches Klinikum, Karlsruhe
,
Anna Sophie Hoffmann
14   Hals-, Nasen- und Ohrenklinik, UKE, Hamburg, Germany (Ringgold ID: RIN37734)
,
Thomas K. Hoffmann
15   Klinik für Hals, Nasen- und Ohrenheilkunde und Kopf- und Halschirurgie, Universitätsklinikum Ulm, Ulm, Deutschland
,
Werner Hosemann
16   Klinik für Hals-Nasen-Ohren-Heilkunde, Heliosklinikum, Stralsund
,
Thomas Kuehnel
17   Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Regensburg, Regensburg, Germany (Ringgold ID: RIN39070)
,
Martin Laudien
18   Klinik für Hals-, Nasen-, Ohrenheilkund, Kopf- und Halschirurgie, Christian-Albrechts-Universität Kiel, Kiel, Germany
,
Bernhard Olzowy
19   HNO-Zentrum Landsberg am Lech, Landsberg
,
Kim-Victoria Seibert
20   EWIG NORD Rechtsanwälte PartmbB, Bonn
,
Fabian Sommer
15   Klinik für Hals, Nasen- und Ohrenheilkunde und Kopf- und Halschirurgie, Universitätsklinikum Ulm, Ulm, Deutschland
,
Thomas Verse
21   Klinik für Hals-, Nasen- und Ohrenheilkunde, Asklepios Klinikum Harburg, Hamburg
,
Susanne Wiegand
22   Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Plastische Operationen, Universität Leipzig, Leipzig, Germany
23   Klinik für Hals-, Nasen-, Ohrenheilkund, Kopf- und Halschirurgie, Christian-Albrechts-Universität Kiel, Kiel, Germany
,
Tanja Hildenbrand 
24   Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitatsklinikum Freiburg, Freiburg, Germany (Ringgold ID: RIN14879)
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Zusammenfassung

Hintergrund Die Ambulantisierung rhinochirurgischer Eingriffe wird derzeit intensiv diskutiert und insbesondere von politischer Seite stark propagiert. Viele Fragen zur Stratifizierung in ambulante oder stationäre Durchführung sind unklar. Insbesondere das Vorgehen bei Anwendung von Nasentamponaden ist bisher nicht ausreichend diskutiert.

Material und Methoden Entwicklung einer Checkliste zur ambulanten Durchführung rhinochirurgischer Operationen unter Berücksichtigung der aktuellen Literatur.

Ergebnisse und Schlussfolgerungen Nach umfassender Auswertung der Literatur und Analyse von Risikofaktoren wird eine Liste von stationär durchzuführenden rhinochirurgischen Operationen definiert. Es wird eine Checkliste für die ambulante oder stationäre Durchführung rhinochirurgischer Operationen vorgelegt, die soziale, allgemeine medizinische und spezifische operationsbedingte Gründe berücksichtigt und hierbei die Anwendung von Nasentamponaden einschließt. Sie wird ergänzt durch eine Checkliste, anhand derer Kriterien die Entlassungsfähigkeit von Patienten nach einer ambulant geplanten rhinochirurgischen Operation bewertet wird.

Abstract

Objective Currently, there is an intensive discussion on advancing and expanding outpatient rhinosurgical procedures. Many questions about how to stratify into out- and inpatient procedures are still not sufficiently clarified. Particularly, the use of nasal packing materials is not adequately discussed.

Material and Methods Development of a checklist to stratify sinunasal procedures into in- or outpatient procedures with consideration of current scientific literature and risk factors.

Results and conclusions After comprehensive assessment of the literature and analysis of specific risk factors, a list of sinunasal procedures is presented, which should be performed as inpatient procedures. We present a checklist for in- and outpatient sinunasal procedures, which considers social, medical and surgical factors as well as the use of nasal packing materials. Furthermore, a checklist is added to assess, whether patients are ready for discharge after a planned outpatient procedure.

Schlüsselwörter

Rhinochirurgie - Nasennebenhöhlenoperation - Ambulantisierung - stationäre Durchführung - Nasentamponade - Komplikationen - Blutung - Aspiration - Checkliste - Entlassfähigkeit

Keywords

Sinunasal surgery - FESS - nasal packing - complications - postoperative bleeding - aspiration - outpatient procedure - inpatient procedure - checklist - discharge management


Publication History

Article published online:
30 September 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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