In clinical medical work, we often encounter patients or family members to consult some questions about the current surgical treatment for colorectal cancer. For example: 1. Once colorectal cancer is diagnosed, should it be removed endoscopically or removed laparoscopically, or should it be treated by open major surgery? 2. Can the so-called minimally invasive treatment of colorectal cancer cut the lesion cleanly, or is it for aesthetics, less trauma, or good prognosis? 3.How many days are usually hospitalized for endoscopic or laparoscopic surgery? As a specialist in gastrointestinal surgery, I would like to share my views on the above three typical questions that patients and families are eager to understand: First, since the early screening of colorectal cancer in major cities, the early detection rate of colorectal cancer has increased significantly, especially precancerous lesions, polyps or adenoma-like focal carcinomas of the colon are also detected in many cases. Then, once the whole colonoscopy and biopsy suggests colorectal cancer, hyperplastic polyps or adenomas >5mm, surgery is generally required. Depending on the nature of the lesion, the size of the tumor, the base and the growth pattern, endoscopic resection, laparoscopic or open surgical resection can be performed. For most of the polyps or adenomas that are small in size and have been biopsied as benign, they can be removed by fiberoptic colonoscopy. For those polyps or adenomas >5 cm in size, with surface erosion and bleeding with ulcer formation, or small but hard infiltrative lesions, although the pathology suggests benign, specialists are still highly alert to false negative results due to biopsy sampling and other factors; in addition, some elderly and frail patients with early stage carcinomas less than 3 cm in size, or those less than 8 cm from the anus, accounting for less than 1/3 weeks of the intestinal canal, are clearly diagnosed by endoscopic ultrasound. /If the lesion is located in the sigmoid colon or rectum, the tumor can also be removed through the anus or by transanal endoscopic microscopic technique (TEM). For the rest of patients with colorectal adenocarcinoma clearly diagnosed by pathological examination, those who have no obvious distant multiple metastases in the preoperative evaluation and can tolerate anesthesia and surgery are currently recommended to undergo radical resection of the cancer either laparoscopically or openly at the earliest possible time. Except for patients with very large tumor size, cancer invading plasma membrane and involving surrounding organs, enlarged lymph node fusion at the root of blood vessels, cancer with obstruction, history of multiple major abdominal surgeries and those who cannot tolerate pneumoperitoneum, laparoscopic-assisted or total laparoscopic surgery is preferred for radical treatment of colon cancer. Of course, in addition to the experience in open radical colon cancer surgery, the requirements for the chief surgeon and assistant should have the relevant advanced laparoscopic training and obtain the corresponding qualification before they can carry out laparoscopic radical colon cancer surgery. At present, international guidelines for colorectal cancer treatment also recommend laparoscopic radical surgery for early to mid-stage colon cancer as the standard procedure. Of course, for patients with low to mid-stage rectal cancer and invasion of rectal mesentery and consideration of local lymph node metastasis, laparoscopic surgery shall be performed after standardized radiotherapy before surgery, which can improve the rate of anal preservation and reduce the rate of postoperative recurrence. Second, in answering this question, it reminds me that the first laparoscopic cholecystectomy in the world was first performed by a French surgeon in 1987, and laparoscopic cholecystectomy has been commonly performed in China since the 1990s. During this period, it has also undergone a gradual process of awareness, both among fellow surgeons themselves and patients. With the evidence-based clinical practice and big data, the minimally invasive advantages of laparoscopic cholecystectomy have been clearly demonstrated, both in terms of efficacy, trauma size, aesthetics and postoperative recovery. In terms of postoperative hospitalization time, it used to take a week to be discharged after open surgery, but now it is possible to be discharged one day or even the same night after surgery. Similarly, laparoscopic colorectal cancer surgery has been performed in China for more than 20 years. The performance of laparoscopic colorectal cancer surgery has been widely recognized and supported by evidence-based medical evidence. On the one hand, the laparoscopic imaging system has a 3-5 times magnification effect, and for gastrointestinal surgeons skilled in laparoscopic techniques, it is more convenient than open surgery to explore the distant organs in the abdominal cavity and the severity of intra-abdominal lesions, the identification of microscopic vessels and the recognition of each fascial anatomical gap, especially in the radical tumor surgery, not only the In particular, in radical tumor surgery, not only the removal of intestinal canal, but also the removal of lymph nodes at the root of blood vessels and the whole fast removal of tissues in the corresponding drainage area are emphasized in order to achieve complete radical treatment of tumor. Perhaps you understand that laparoscopic surgery only has a few keyhole-sized incisions in the abdomen, but it also follows the principle of radical tumor treatment in the abdominal cavity. Because of the magnification effect of laparoscopy, the dissection is more precise, the lymphatic dissection at the root of blood vessels is more thorough, the bleeding is less, and the postoperative recovery is faster. On the other hand, when various procedures of laparoscopic colorectal tumors are successfully accomplished and various key techniques are established, it also promotes the standardization of the corresponding surgical quality. Therefore, it is said that laparoscopic radical colorectal cancer surgery is not only minimally invasive, less painful and faster recovery, but also better reflects the requirements of radical tumor resection, and the local recurrence, disease-free survival and overall survival are comparable to that of open surgery. Third, general adenomas or polyps can go home after endoscopic removal on the same day, while for polyps or adenomas with diameter >3cm or wide base, the endoscopist may stay in the hospital for several hours for observation depending on the intraoperative situation; patients with early colorectal cancer suitable for endoscopic resection (EMR or ESD) need to be hospitalized for 1-3 days due to the large surgical invasion. In addition, patients with colorectal cancer requiring laparoscopic surgical treatment can generally recover and be discharged from the hospital 5-7 days after surgery if they recover normally and have no postoperative complications.