esd surgery should be written ESD surgery, refers to endoscopic submucosal dissection, the operation may lead to intestinal perforation situation occurs after the operation, after the operation need to be closely followed up and observed. Endoscopic submucosal dissection is a minimally invasive treatment for precancerous lesions and early cancers of the digestive tract. With the assistance of gastroenteroscopy, the site of the lesion is identified, then the lesion is stained and processed, followed by incision around the lesion with a needle incision knife, and finally the lesion is peeled off by an IT knife to complete the resection of the lesion. The procedure is less damaging to the patient, who may not have too obvious self sensation, and the postoperative recovery is faster with relatively fewer complications. However, if the operation is not performed properly and the intestinal wall is cut too deeply, it may lead to intestinal perforation. In addition, during the operation, local ligature treatment or electrocoagulation cauterization may be carried out, and tissue necrosis may occur in the operated area after the operation, which may also induce intestinal perforation. Intestinal perforation is a serious complication, therefore, patients must be under the guidance of the doctor’s formal treatment after surgery. At the same time, close follow-up observation should be made, if the patient is found to have abdominal pain, nausea and vomiting, bloody stools, fever and chills, etc., and when it is clear that the intestinal perforation is occurring, it is necessary to carry out treatment as soon as possible to avoid aggravation of the condition.