With the increase of the average life expectancy of Chinese residents and the gradual development of the aging of the population, the proportion of elderly patients among the patients with gastrointestinal tumors is increasing. In the case of elderly patients older than 75 years old, the functions of various organs of the body are decreasing to different degrees, and they are often combined with heart disease, diabetes, hypertension, endocrine metabolic disorders, etc. The perioperative preparation is complicated, and postoperative organ insufficiency and even failure of heart and lung organs are likely to occur. It is a great challenge for clinicians to formulate comprehensive treatment and perioperative management plans for elderly tumor patients according to the latest international and domestic treatment guidelines, to develop individualized treatment plans, to provide the most reasonable and appropriate surgical plans for gastroenteropancreatic tumor patients, and to improve the survival and quality of life of gastroenteropancreatic tumor patients. With the great progress and improvement of medical technology and level in the past 30 years, we believe that advanced age is not a contraindication or a major risk factor for surgery, but the key is to evaluate the patient’s general physiological condition and the functional status of important organs. As long as the preoperative evaluation and preparation are adequate, most of the surgeries for elderly patients can be performed safely. The Department of Gastrointestinal Peripheral Vascular Surgery, under the guidance of Professor Huang Shunrong, the director of the department, and the efforts of Dr. Mai Wei, the deputy director of the department, and all of his colleagues, in conjunction with other related departments of the hospital, has achieved better results for elderly patients older than 75 years old who need surgical treatment. The following measures were taken: ① Preoperative adequate nutrition and assessment: comprehensive examination and accurate assessment of heart, liver, lung, kidney, brain function, coagulation mechanism, blood sugar and blood pressure, correction of malnutrition and anemia, control of pulmonary infection, blood pressure and blood sugar, and preoperative diagnosis and treatment of heart disease. Pre-operative consultation with relevant departments (such as anesthesiology) to assess and regulate the function of each organ. And, pay attention to psychological care before surgery, improve the negative state of mind of worry, and enhance the confidence of patients to overcome the disease. ② Formulation of reasonable surgical plan: for super senior gastrointestinal malignant tumors, due to decreased tolerance, not all radical surgery with huge trauma may be adopted. According to the actual situation of patients, patients may be recommended to choose minimally invasive laparoscopic, traditional open or interventional surgical methods, and adopt comprehensive treatment plans such as radical treatment, palliation, diversion, rerouting or radiotherapy. ③ Intraoperative trauma reduction: the latest ligation-free surgical technique proposed by our hospital is used to perform surgery, reduce the difficulty of surgery, shorten the time of surgery and anesthesia, reduce the amount of bleeding and the amount of postoperative trauma bleeding and oozing, and avoid and reduce blood transfusion as much as possible. ④ Postoperative monitoring and elaborate consultation and treatment plan: routinely placed in the monitoring ward after surgery to ensure water-electrolyte balance, emphasize nutritional support, avoid urinary retention, prevent and treat pulmonary and incisional infections, routinely control pain to prevent it from inducing hypertension, cardiac rhythm disturbance and myocardial ischemia, and promptly invite relevant disciplines to jointly manage various complications. Early movement of limbs to prevent deep vein and cerebral thrombosis. Special emphasis is placed on the prevention and treatment of heart failure, with emphasis on limiting excessive and rapid fluid or imbalance in and out. Pay attention to postoperative warmth, back patting and sputum excretion, prevention and control of pulmonary infection, routine nebulized expectoration, and encouragement to assist patients in postoperative turning and deep breathing.