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<p>The increasing shift toward outpatient surgical care represents a&#xa0;major development in healthcare systems and is driven by both medical advances and economic as well as health policy considerations. This article provides an evidence-based assessment of ambulatory surgery, with a&#xa0;particular focus on structural requirements and the current German S3 guideline on benign uterine diseases. International data demonstrate that high rates of outpatient surgery can only be safely achieved within clearly defined structural frameworks and standardized decision-making processes. The available evidence comparing outpatient and inpatient care is heterogeneous and limited by a&#xa0;substantial risk of bias, preventing any general conclusion regarding the superiority of either setting. Instead, outcomes largely depend on patient selection, individual risk profiles, and the organization of care. Using minimally invasive hysterectomy as an example, outpatient treatment is shown to be feasible but requires careful, individualized risk assessment. A&#xa0;generalized shift toward outpatient care is therefore not appropriate. Decisions regarding the treatment setting should remain physician-led and be based on shared decision-making with the patient, rather than being primarily driven by economic considerations.</p>

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Ambulantisierung operativer Eingriffe – Evidenz insbesondere am Beispiel der Leitlinie zur Hysterektomie

  • 期刊论文

  • 发表日期：

    2026年5月8日

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  • Cosima Brucker,
  • Thomas Dimpfl,
  • Anton J. Scharl

摘要

The increasing shift toward outpatient surgical care represents a major development in healthcare systems and is driven by both medical advances and economic as well as health policy considerations. This article provides an evidence-based assessment of ambulatory surgery, with a particular focus on structural requirements and the current German S3 guideline on benign uterine diseases. International data demonstrate that high rates of outpatient surgery can only be safely achieved within clearly defined structural frameworks and standardized decision-making processes. The available evidence comparing outpatient and inpatient care is heterogeneous and limited by a substantial risk of bias, preventing any general conclusion regarding the superiority of either setting. Instead, outcomes largely depend on patient selection, individual risk profiles, and the organization of care. Using minimally invasive hysterectomy as an example, outpatient treatment is shown to be feasible but requires careful, individualized risk assessment. A generalized shift toward outpatient care is therefore not appropriate. Decisions regarding the treatment setting should remain physician-led and be based on shared decision-making with the patient, rather than being primarily driven by economic considerations.