According to the 2013 China Gastrointestinal Mesenchymal Tumor Expert Consensus, observation is recommended for gastric mesenchymal tumors less than 2 cm in diameter, and surgery is not recommended. However, in the course of clinical practice, we found that some small mesenchymal tumors were observed for six months and some patients developed extensive abdominal metastasis, and surgery is still recommended in the patients I treat. Gastrointestinal mesenchymal tumor (GIST) is an aggressive tumor with potential malignant tendency. Unlike gastric cancer, it does not originate from the inner mucosa of the gastrointestinal tract, but is a tumor of submucosal cells, and its malignancy is not as distinctly benign as that of mucosal origin. GIST GIST is most commonly found in the stomach and is often discovered inadvertently during gastroscopy. The tumor size varies from 0.8cm to 20cm in diameter, and can be solitary or multiple. It is well-defined, without envelope, and grows into the lumen as a polyp-like mass often accompanied by ulcer formation, and grows outside the plasma membrane to form a subplasma mass. Clinical signs of gastrointestinal bleeding and palpable masses are common. In mesenchymal tumors located in the abdominal cavity, the mass is often large in size. The tumor has a nodular or lobulated gross morphology, with grayish-white, red, uniform cut surface, hard and tough texture, ulcer formation on the mucosal surface, visible hemorrhage, necrosis, mucinous changes and cystic changes. Chunli Zhang, Department of Hernia and Abdominal Wall and Thyroid Surgery, Zhengzhou People’s Hospital The treatment of GIST is surgical resection as the most basic treatment, and molecularly targeted drugs are needed postoperatively to reduce the risk of recurrence for medium and high-risk cases. Since lymphatic metastasis rarely occurs in gastric mesenchymal tumors, lymph node dissection is not required. However, mesenchymal tumors are highly susceptible to implantation and metastasis, so complete resection of the tumor is required, and tumor breakdown is an important risk factor. The current surgical treatment for gastric mesenchymal tumor is complete resection of the mass, avoiding tumor breakage and preserving the function of the stomach as much as possible. For gastric mesenchymal tumors less than 1 cm, there is some disagreement as to whether early resection is necessary because of the generally low malignancy. The clinical guidelines of more countries recommend regular gastroscopic review and resection if there is significant growth, and unresection if there is no significant change, especially in older cases. 2013 China Gastrointestinal Mesenchymal Tumor Expert Consensus does not recommend surgery for mesenchymal tumors smaller than 2 cm. After observation and follow-up, we believe that early surgery for gastric mesenchymal tumors of 1CM – 2CM may benefit some patients. 2013 China Gastrointestinal Mesenchymal Tumor Expert Consensus is a guideline for treatment, not a regulation, and is different from the professional norms issued by the Medical Secretary of the Ministry of Health, which should still be individualized.