Rectal masses invading the submucosa can be subjected to ESD surgery. ESD surgery can be performed in cases confined to the mucosal layer as well as in cases with no lymph node metastasis in the submucosal layer, and the prognosis is also better and the surgical trauma is less. ESD surgery is endoscopic submucosal dissection, which is mainly applied to precancerous lesions in the digestive tract and early digestive tract cancers, such as giant flat polyps. It is a minimally invasive surgery with little damage to the human body, short recovery time and better prognosis, and is now widely used in clinical practice. The procedure can be done for swellings of superficial origin in the muscular and submucosal layers of the mucosa, with complete stripping of the lesion by esd. Patients who exceed the submucosal layer to reach the muscular layer cannot undergo ESD surgery, and will be at risk of perforation. As to whether ESD surgery can be performed, it is necessary to improve the relevant examination, according to the individual situation, actively cooperate with the doctor to standardize the treatment, choose the most appropriate treatment plan, to ensure a good prognosis.