Optimizing outcomes of surgery in advanced age--perioperative factors to consider.

The gynecologic surgeon should be knowledgeable about the normal physiologic changes associated with aging and skilled at assessing baseline medical comorbidities, neuropsychiatric, nutritional, social, and functional status as increasing numbers of older women seek and undergo surgical interventions to improve their quality of life. A multidisciplinary approach to the perioperative care of the older woman, aiming for prevention and early intervention, can help minimize both typical surgical complications and "geriatric" complications.