Total gastrectomy can be performed if the 75 year old is healthy and well nourished, can tolerate the surgery, and the surgery is effective in prolonging life or improving the quality of life. Contraindications to major gastrectomy include advanced gastric tumors with extensive systemic metastases, those who are in extremely poor health and cannot tolerate surgery and anesthesia, severe cardiopulmonary dysfunction, and those with contraindications to anesthesia. It does not explicitly say that 75-year-old people must not be able to do gastric major operation. If the elderly patients can physically tolerate the surgery, it is in line with the indications for surgery. If the physical condition of 75-year-old patients can support surgery, but also need to consider the patient’s own underlying disease and the need for surgery, such as the patient after gastric resection can be enteral nutrition and a longer continuation of life may be possible, can be considered for surgical treatment. It is recommended to seek medical advice, consult a doctor and choose the appropriate treatment under the doctor’s guidance.