The tendency that elderly patients with multiple underlying diseases undergo elective laparoscopic surgeries is increasing. While laparoscopic surgery has the advantage of minimal invasiveness, CO2 pneumoperitoneum and the Trendelenburg positioning significantly affect respiratory function and hemodynamics, which require proper regulation and collaboration between anesthesiologist and surgeon. This patient underwent radical colorectal surgery with a definite history of pulmonary heart disease. His high‑risk factors of coronary heart disease and thromboembolism complications were screened out as well before surgery. Perioperative management ensured the patient's safety, which included accurate evaluation of operation timing and surgical contraindications, as well as reasonable multidisciplinary therapeutic interventions. The patient's ideal prognosis is also derived partly from the relieved ileus by effective conservative treatment before surgery.