{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,3,29]],"date-time":"2025-03-29T16:52:36Z","timestamp":1743267156522,"version":"3.28.0"},"reference-count":26,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Laryngorhinootologie"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>Mit Beginn des Jahres 2023 haben sich in der Regelung f\u00fcr das ambulante Operieren in Deutschland erhebliche \u00c4nderungen ergeben, die in einem trilateralen Vertrag der Selbstverwaltung zwischen dem Spitzenverband der gesetzlichen Krankenversicherungen, der Deutschen Krankenhausgesellschaft und der Kassen\u00e4rztlichen Bundesvereinigung niedergelegt wurden. Hier wurden unter anderem in einem Katalog Tatbest\u00e4nde angegeben, unter denen eine Operation nicht oder nur fraglich ambulant durchgef\u00fchrt werden sollte. In diesem Katalog wurde zum Patientenalter ausgef\u00fchrt: \u201eBis zur Vollendung des ersten Lebensjahres kann eine station\u00e4re Durchf\u00fchrung einer Leistung begr\u00fcndet sein.\u201c Diese Formulierung f\u00fcr sich bedeutet, dass Kinder ab einem Jahr regelhaft ambulant zu operieren sind.<\/jats:p><jats:p>In den wissenschaftlichen Fachgesellschaften f\u00fcr HNO-Heilkunde, Kopf und Halschirurgie sowie f\u00fcr An\u00e4sthesiologie und Intensivmedizin regten sich Zweifel, ob diese Altersgrenze auch f\u00fcr Operationen im Rachen wie Adenotomie oder Tonsillotomie wissenschaftlich begr\u00fcndbar sei.<\/jats:p><jats:p>Es wurde eine Recherche in internationalen Leitlinien sowie in der internationalen Literatur durchgef\u00fchrt und die dortigen Aussagen bewertet. Die Ergebnisse dieser Literaturrecherche wurden mit Vertretern der Arbeitsgemeinschaft P\u00e4diatrische HNO-Heilkunde (AG P\u00e4dHNO), der Deutschen Gesellschaft f\u00fcr HNO-Heilkunde, Kopf- und Hals-Chirurgie (DGHNO-KHC) und dem wissenschaftlichen Arbeitskreis Kinderan\u00e4sthesie (WAKKA) der Deutschen Gesellschaft f\u00fcr An\u00e4sthesiologie und Intensivmedizin (DGAI) in Konferenzen beraten.<\/jats:p><jats:p>Diese Konsensfindung ergab, dass eine strikte Altersgrenze mit dem vollendeten ersten Lebensjahr f\u00fcr die ambulante Durchf\u00fchrung von Adenotomien und Tonsillotomien nicht sachgerecht ist. Zun\u00e4chst ist \u00fcberhaupt die Angabe einer strikten Altersgrenze fragw\u00fcrdig, da unabh\u00e4ngig vom Alter etliche andere medizinische und soziale Faktoren Einfluss auf die verantwortungsvolle Durchf\u00fchrbarkeit ambulanter Operationen haben. Im Weiteren ist die Altersgrenze von einem Jahr mit Blick auf Literatur, Leitlinien und praktische Aus\u00fcbung im internationalen Bereich nicht als sachgerecht anzusehen. Die Bewertung der Literatur und die Beachtung der Durchf\u00fchrung im internationalen Bereich lassen eine Altersgrenze eher in dem Bereich von 2\u20133 Jahren als sachgerecht erscheinen.<\/jats:p><jats:p>Diese \u00dcbersichtsarbeit gibt den verantwortlichen \u00c4rzten vielerlei Erkenntnisse, Aspekte und Argumente an die Hand, um die Entscheidung zur ambulanten oder station\u00e4ren Durchf\u00fchrung dieser Operationen sachgerecht und verantwortungsvoll treffen zu k\u00f6nnen.<\/jats:p>","DOI":"10.1055\/a-2216-8474","type":"journal-article","created":{"date-parts":[[2023,12,13]],"date-time":"2023-12-13T00:02:31Z","timestamp":1702425751000},"page":"17-24","source":"Crossref","is-referenced-by-count":1,"title":["Stellungnahme zur Altersuntergrenze bei der ambulanten Durchf\u00fchrung von Adenotomien und Tonsillotomien"],"prefix":"10.1055","volume":"103","author":[{"given":"T.","family":"Deitmer","sequence":"additional","affiliation":[{"name":"Arbeitsgemeinschaft p\u00e4diatrische HNO-Heilkunde (AG P\u00e4dHNO) der Deutschen Gesellschaft f\u00fcr HNO-Heilkunde, Kopf- und Hals-Chirurgie (DGHNO-KHC), Bonn"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C. E.","family":"Beck","sequence":"additional","affiliation":[{"name":"Wissenschaftlicher Arbeitskreis Kinderan\u00e4sthesie (WAKKA) der Deutschen Gesellschaft f\u00fcr An\u00e4sthesiologie und Intensivmedizin (DGAI), Klinik f\u00fcr An\u00e4sthesiologie und Intensivmedizin, Medizinische Hochschule Hannover, Hannover"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K.","family":"Becke-Jakob","sequence":"additional","affiliation":[{"name":"Wissenschaftlicher Arbeitskreis Kinderan\u00e4sthesie (WAKKA) der Deutschen Gesellschaft f\u00fcr An\u00e4sthesiologie und Intensivmedizin (DGAI), Berufsverband Deutscher An\u00e4sthesistinnen und An\u00e4sthesisten. Klinik Hallerwiese-Cnopfsche Kinderklinik, N\u00fcrnberg"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Eich","sequence":"additional","affiliation":[{"name":"Wissenschaftlicher Arbeitskreis Kinderan\u00e4sthesie (WAKKA) der Deutschen Gesellschaft f\u00fcr An\u00e4sthesiologie und Intensivmedizin (DGAI), Abteilung An\u00e4sthesie, Kinderintensiv- und Notfallmedizin, Kinder- und Jugendkrankenhaus Auf der Bult, Hannover"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Hackenberg","sequence":"additional","affiliation":[{"name":"Arbeitsgemeinschaft p\u00e4diatrische HNO-Heilkunde (AG P\u00e4dHNO) der Deutschen Gesellschaft f\u00fcr HNO-Heilkunde, Kopf- und Hals-Chirurgie (DGHNO-KHC), Klinik und Poliklinik f\u00fcr Hals-, Nasen- und Ohrenkrankheiten, plastische und \u00e4sthetische Operationen, Universit\u00e4tsklinikum W\u00fcrzburg"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T. K.","family":"Hoffmann","sequence":"additional","affiliation":[{"name":"Arbeitsgemeinschaft p\u00e4diatrische HNO-Heilkunde (AG P\u00e4dHNO) der Deutschen Gesellschaft f\u00fcr HNO-Heilkunde, Kopf- und Hals-Chirurgie (DGHNO-KHC), Klinik f\u00fcr Hals-Nasen-Ohrenheilkunde, Kopf- und Hals-Chirurgie, Universit\u00e4tsklinikum Ulm"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Koitschev","sequence":"additional","affiliation":[{"name":"Arbeitsgemeinschaft p\u00e4diatrische HNO-Heilkunde (AG P\u00e4dHNO) der Deutschen Gesellschaft f\u00fcr HNO-Heilkunde, Kopf- und Hals-Chirurgie (DGHNO-KHC), Klinik f\u00fcr Hals-Nasen-Ohrenkrankheiten, Plastische Operationen, Klinikum Stuttgart"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"L\u00f6hler","sequence":"additional","affiliation":[{"name":"Deutscher Berufsverband der HNO-\u00c4rzte, Neum\u00fcnster"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K.","family":"R\u00f6her","sequence":"additional","affiliation":[{"name":"Wissenschaftlicher Arbeitskreis Kinderan\u00e4sthesie (WAKKA) der Deutschen Gesellschaft f\u00fcr An\u00e4sthesiologie und Intensivmedizin (DGAI), Klinik und Poliklinik f\u00fcr An\u00e4sthesiologie, Universit\u00e4tsklinikum Eppendorf, Hamburg"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Sittel","sequence":"additional","affiliation":[{"name":"Arbeitsgemeinschaft p\u00e4diatrische HNO-Heilkunde (AG P\u00e4dHNO) der Deutschen Gesellschaft f\u00fcr HNO-Heilkunde, Kopf- und Hals-Chirurgie (DGHNO-KHC), Klinik f\u00fcr Hals-Nasen-Ohrenkrankheiten, Plastische Operationen, Klinikum Stuttgart"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H. J.","family":"Welkoborsky","sequence":"additional","affiliation":[{"name":"Arbeitsgemeinschaft p\u00e4diatrische HNO-Heilkunde (AG P\u00e4dHNO) der Deutschen Gesellschaft f\u00fcr HNO-Heilkunde, Kopf- und Hals-Chirurgie (DGHNO-KHC), Klinik f\u00fcr HNO-Heilkunde, Krankenhaus Nordstadt, Kliniken Region Hannover"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Wienke","sequence":"additional","affiliation":[{"name":"Fachanwalt f\u00fcr Medizinrecht, Justiziar der Deutschen Gesellschaft f\u00fcr HNO-Heilkunde, Kopf- und Hals-Chirurgie (DGHNO-KHC), Bonn"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"Badelt","sequence":"additional","affiliation":[{"name":"Wissenschaftlicher Arbeitskreis Kinderan\u00e4sthesie (WAKKA) der Deutschen Gesellschaft f\u00fcr An\u00e4sthesiologie und Intensivmedizin (DGAI), Klinik f\u00fcr An\u00e4sthesie und Kinderan\u00e4sthesie, Krankenhaus Barmherzige Br\u00fcder Regensburg, Klinik St. Hedwig, Regenburg"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,12,12]]},"reference":[{"volume-title":"SFORL, Societe francaise d\u2019ORL et de chirurgie de la face et du cou: Recommandation pour la Pratique Clinique: Amygdalectomie de l\u2019enfant","year":"2020","author":"E ME Lescanne","key":"ref1"},{"volume-title":"Day-case tonsillectomy guidance, executive summary 2023","year":"2023","author":"Otolaryngology BAfP","key":"ref2"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1177\/0194599818801757","article-title":"Clinical Practice Guideline: Tonsillectomy in Children (Update)","volume":"160","author":"R B Mitchell","year":"2019","journal-title":"Otolaryngol Head Neck Surg"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1177\/0194599818807917","article-title":"Clinical Practice Guideline: Tonsillectomy in Children (Update)-Executive Summary","volume":"160","author":"R B Mitchell","year":"2019","journal-title":"Otolaryngol Head Neck Surg"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1177\/01945998211015176","article-title":"Surgical Techniques for Tonsillectomy and Perioperative Respiratory Complications in Children","volume":"166","author":"R G Baijal","year":"2022","journal-title":"Otolaryngol Head Neck Surg"},{"key":"ref6","first-page":"A5536","article-title":"Evaluation of day-care tonsil surgery in young children","volume":"66","author":"A M Bruaset","year":"2019","journal-title":"Dan Med J"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"109796","DOI":"10.1016\/j.ijporl.2019.109796","article-title":"Pediatric adenoidectomy in the very young child and indications for postoperative inpatient admission","volume":"130","author":"S R Chorney","year":"2020","journal-title":"Int J Pediatr Otorhinolaryngol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"102546","DOI":"10.1016\/j.amjoto.2020.102546","article-title":"Rate and risk factors for post-adenotonsillectomy complications in children under 24 months and 24 to 36 months old","volume":"41","author":"F Cooper","year":"2020","journal-title":"Am J Otolaryngol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"2317","DOI":"10.1001\/jama.2022.8679","article-title":"Association of Patient Characteristics With Postoperative Mortality in Children Undergoing Tonsillectomy in 5 US States","volume":"327","author":"M B Edmonson","year":"2022","journal-title":"JAMA"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"E389","DOI":"10.1002\/lary.27795","article-title":"Revisiting age-related admission following tonsillectomy in the pediatric population","volume":"129","author":"S S Evans","year":"2019","journal-title":"Laryngoscope"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1572","DOI":"10.1111\/anae.14844","article-title":"Risk factors for children requiring adenotonsillectomy and their impact on postoperative complications: a retrospective analysis of 2000 patients","volume":"74","author":"T Gehrke","year":"2019","journal-title":"Anaesthesia"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1111\/anae.15562","article-title":"Safety of day-case paediatric tonsillectomy in England: an analysis of administrative data for the Getting It Right First Time programme","volume":"77","author":"W K Gray","year":"2022","journal-title":"Anaesthesia"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1002\/lio2.340","article-title":"Adenotonsillectomy and postoperative respiratory adverse events: A retrospective study","volume":"5","author":"T B Hamilton","year":"2020","journal-title":"Laryngoscope Investig Otolaryngol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"41","DOI":"10.5664\/jcsm.8118","article-title":"Predictors of postoperative respiratory complications in children undergoing adenotonsillectomy","volume":"16","author":"S L Katz","year":"2020","journal-title":"J\u00a0Clin Sleep Med"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1535","DOI":"10.1002\/ohn.238","article-title":"Preoperative Predictors of Severe Respiratory Events After Tonsillectomy: Consideration for Pediatric Intensive Care Admission","volume":"168","author":"E M Kirkham","year":"2023","journal-title":"Otolaryngol Head Neck Surg"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"699","DOI":"10.1177\/0194599819844791","article-title":"A Cross-sectional Analysis of Pediatric Ambulatory Tonsillectomy Surgery in the United States","volume":"161","author":"Y F Kou","year":"2019","journal-title":"Otolaryngol Head Neck Surg"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"109668","DOI":"10.1016\/j.ijporl.2019.109668","article-title":"Age-related causes of emergency department visits after pediatric adenotonsillectomy at a tertiary pediatric referral center","volume":"127","author":"N R Lindquist","year":"2019","journal-title":"Int J Pediatr Otorhinolaryngol"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1016\/j.ijporl.2019.02.026","article-title":"Tertiary hospital retrospective observational audit of tonsillectomy","volume":"121","author":"H Ng","year":"2019","journal-title":"Int J Pediatr Otorhinolaryngol"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"102765","DOI":"10.1016\/j.amjoto.2020.102765","article-title":"Adenoidectomy: Inpatient criteria study","volume":"42","author":"R Patel","year":"2021","journal-title":"Am J Otolaryngol"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1310","DOI":"10.1177\/00034894211067615","article-title":"A National Analysis of Inpatient Pediatric Adenoidectomy","volume":"131","author":"F Yan","year":"2022","journal-title":"Ann Otol Rhinol Laryngol"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"111286","DOI":"10.1016\/j.ijporl.2022.111286","article-title":"Admission practices following pediatric tonsillectomy: A survey of ASPO members","volume":"162","author":"J T Rollins","year":"2022","journal-title":"Int J Pediatr Otorhinolaryngol"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1016\/j.jss.2022.05.033","article-title":"Trial and Error: Learning From Malpractice Claims in Childhood Surgery","volume":"279","author":"J M Prieto","year":"2022","journal-title":"J Surg Res"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1097\/EJA.0000000000000951","article-title":"Epidemiology and incidence of severe respiratory critical events in ear, nose and throat surgery in children in Europe: A prospective multicentre observational study","volume":"36","author":"K Virag","year":"2019","journal-title":"Eur J Anaesthesiol"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"744","DOI":"10.1016\/j.ijporl.2014.01.032","article-title":"Routine post-operative intensive care is not necessary for children with obstructive sleep apnea at high risk after adenotonsillectomy","volume":"78","author":"M Theilhaber","year":"2014","journal-title":"Int J Pediatr Otorhinolaryngol"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"1385","DOI":"10.1016\/j.ijporl.2011.07.034","article-title":"A pilot study to identify pre- and peri-operative risk factors for airway complications following adenotonsillectomy for treatment of severe pediatric OSA","volume":"75","author":"C A Hill","year":"2011","journal-title":"Int J Pediatr Otorhinolaryngol"},{"volume-title":"Beschluss des Gemeinsamen Bundesausschusses \u00fcber die Erstfassung der Regelungen zu einem gestuften System von Notfallstrukturen in Krankenh\u00e4usern gem\u00e4\u00df \u00a7136c Abs. 4 SGB V","year":"2018","author":"J GB Hecken","key":"ref26"}],"container-title":["Laryngo-Rhino-Otologie"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2216-8474.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T12:36:45Z","timestamp":1730810205000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2216-8474"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,12]]},"references-count":26,"journal-issue":{"issue":"01","published-online":{"date-parts":[[2024,1,5]]},"published-print":{"date-parts":[[2024,1]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2216-8474","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0935-8943","1438-8685"],"issn-type":[{"type":"print","value":"0935-8943"},{"type":"electronic","value":"1438-8685"}],"subject":[],"published":{"date-parts":[[2023,12,12]]}}}