Gastrointestinal cancers (esophagus, stomach, and colon) are currently on the rise globally, with a tendency for younger age groups. The traditional treatments for GI cancers are: ① surgery, ② laparoscopic gastrectomy, ③ chemotherapy, ④ other immune and biological therapies. Among them, surgery is preferred. Whether it is open-hearted for esophageal cancer or dissection for gastrointestinal cancer, it is more traumatic and the removal of part of the digestive organs has a certain impact on the function and quality of life of the digestive tract. Our ultimate goal in treating cancer is early detection, early treatment and minimally invasive. Endoscopic Submucosal Dissection ESD is a scientific and technological advancement that brings benefits to patients with early-stage cancer of the GI tract. Endoscopic Submucosal Dissection (ESD) is developed from Endoscopic mucosal Resection. Endoscopic submucosal dissection (ESD) has been recognized and recommended by endoscopists all over the world, representing the highest level of technology in endoscopic treatment, and has been used in clinical practice earlier in foreign countries and is favored by the majority of patients. However, the application of ESD in the treatment of early gastrointestinal cancer in China has just started, and there are not many units carrying out ESD. What are the benefits of ESD (endoscopic submucosal dissection)? ① Individualized and targeted treatment. It can ensure complete resection of the tumor while maximizing the preservation of normal tissues and their functions. ② The use of ESD has enabled a large number of patients with GI tumors who previously had to undergo open-heart or open-abdomen surgery to avoid the pain of surgical procedures. The patients who underwent open-chest and open-abdomen surgery had long hospitalization time, high surgical risk and high hospitalization cost, but the patients treated with ESD have less trauma and significantly shorter hospitalization time, especially the patients’ gastrointestinal tract is preserved intact, the surgical risk is small, the patients recover quickly and the quality of life is significantly improved. ③ Small trauma, easily tolerated by patients. ④ Most importantly, endoscopic submucosal dissection (ESD) has the same therapeutic effect as conventional surgery in treating early-stage cancer of the GI tract. How is ESD performed? ① lesion marking ② lesion margin cutting ③ lesion peeling ④ lesion removal and pathological evaluation. Early gastric cancer lesion marking Early gastric cancer lesion margins Early gastric cancer lesion excision Complete excision of lesion tissue What patients with GI disease are suitable for ESD? Endoscopic submucosal dissection (ESD) is indicated for patients with a high likelihood of complete lesion excision and a low likelihood of lymph node metastasis. Overall, almost all mucosal epithelial tumors (including precancerous lesions) and some invasive carcinomas with mild submucosal infiltration are suitable candidates for ESD. What means are used to detect and evaluate lesions as precancerous and early cancers of the GI tract? The application of new techniques and equipment such as electronic endoscopy, magnifying endoscopy, staining endoscopy, narrow-band imaging, and ultrasonic endoscopy has greatly improved the detection and diagnosis of early cancers of the gastrointestinal tract. In particular, the application of ultrasonic endoscopy clarifies the depth of cancer cell invasion and performs staging of lesions. After ESD, the complete lesion tissue is removed and pathological examination is performed to determine the cell typing and cutting edge, which is of course the best assessment and treatment plan for the lesion. Routine electronic endoscopy Esophageal staining Colorectal magnification endoscopy NBI (narrow band imaging) Ultrasound endoscopy How can you know if there is a ticking bomb in your digestive tract? Pre-cancerous lesions and early cancers of the digestive tract are often asymptomatic, and some early cancers have only mild symptoms that are easily ignored. So far, there is no laboratory test that can confirm the diagnosis of GI cancer. Gastrointestinal endoscopy (gastroscopy, colonoscopy) combined with pathological histological examination is still the only effective means to diagnose early GI cancer. Therefore, it is important to have regular gastrointestinal endoscopy, especially for those who have GI tumor patients in their family, so as to identify the “bombs” (precancerous lesions and early cancers of GI tract) as early as possible. Those who have experience in gastrointestinal endoscopy may know that it is uncomfortable, but overcoming the fear is the main thing, and of course there is a better option to have a painless gastrointestinal endoscopy. The Gastroenterology Endoscopy Center of the Second People’s Hospital of Guangdong Province was the first in China to carry out painless gastroenteroscopy in 2000. In other words, drugs with fast onset, fast metabolism and no accumulation effect (intravenous anesthetics with fast awakening and ideal sedation effect) are applied before the gastrointestinal endoscopy (gastroscopy and colonoscopy) examination and treatment. Patients are free of discomfort during the examination, which greatly increases the patient’s compliance with the examination. What should be noted after ESD (Endoscopic Submucosal Dissection)? 1.Rest after surgery, abstain from drinking and eating for 24 hours, and observe whether there are complications such as gastrointestinal perforation and bleeding. 2. Routinely apply hemostasis, prophylactic anti-infection and rehydration treatment. Care for your intestines, ESD is less invasive and low risk, keep your body intact and keep digestive tract lesions away!