[Management of comorbidity and preoperative treatment in ambulatory surgery?]

Prevention of postoperative exacerbation of chronic medical disease requires high standard of safety and quality of care in ambulatory surgery and anesthesia. Age is not a major criterion for selection for ambulatory surgery. Ambulatory surgery may be considered for patients with ASA score I, II or III with stable medical conditions. Preoperative medical condition is not a contra-indication to ambulatory surgery, (except severe or end stage) as long as perioperative organization and patient compliance to perioperative instructions are controlled. In patients with major comorbidity, ambulatory surgery should be considered instead of conventional hospitalization. Preop treatment must be maintained during the perioperative period. Their interruption does not provide any benefit and could exacerbate an otherwise stable chronic disease.