[Surgery in the 4th age. The opinion of the geriatrician]

Mortality and morbidity of surgery in the very old patient is much less than generally accepted. Age on his own is never a good reason to refuse surgical intervention. Good assessment after extended interrogation of patient and family, clinical examination and eventually technical procedures will reveal a number of other diseases. The higher the number of other diseases the higher will be the risk of the operation. More attention is needed for the quality of life after the operation. The fact that the patient will remain independent for the activities of daily living is for the very old patient more important than his 5-year survival. I am wondering why the number of female who come to operation is relatively lower than the men. A possible explanation is the fact that to many very old people receive to much nursing care and not enough real medical care.