Gastrointestinal mesenchymal tumors (GIST) are aggressive tumors with potentially malignant tendencies, most commonly in the stomach. 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. If the diameter of the tumor is <2 cm and the MI is <5/50 high magnification, the tumor is considered extremely low malignancy. Gastric mesenchymal tumors grow intracavernously as polyp-like masses often accompanied by ulcer formation, and extraplasmodially as subplasmodial masses, which can be single or multiple, and extraplasmodial tumors growing outside the stomach are usually detected only after the masses are larger, and the largest masses can exceed 30 cm. Gastrointestinal bleeding and palpable masses are common clinical signs. When the tumor grows, it tends to cause ulceration of the surface mucosa and slow or rapid bleeding from the GI tract, which manifests as anemia or sudden vomiting of blood or black stool, respectively. If bleeding occurs inside the mass, abdominal pain can occur and the mass can suddenly increase in size; necrosis within the mass can cause the patient to develop fever. Gastric mesenchymal tumors are often discovered inadvertently during gastroscopy. Gastroscopy reveals a protruding mass with either a normal surface mucosa or an ulcer deep within the mass. Gastroscopic ultrasound is valuable in the diagnosis of mesenchymal tumors, and the masses are usually homogeneous and hypoechoic. Gastric mesenchymal tumors may also be found inadvertently during pathologic examination of stomachs removed for other reasons and may be small enough in diameter to be visible only microscopically. For gastric mesenchymal tumors up to 2 cm, there is some disagreement as to whether they need to be removed early because they are generally less malignant and may remain unchanged for a long time. Clinical guidelines for diagnosis and treatment in more countries recommend regular gastroscopic review and early resection if ultrasound gastroscopy reveals some risk factors, such as uneven ultrasound echo and irregular morphology, otherwise prophylactic resection is not necessary, especially in older cases. It is important to note that gastrointestinal mesenchymal tumors growing outside the stomach are recommended for resection once detected. The treatment of GIST is surgical resection as the most basic treatment. Since gastric mesenchymal tumors generally do not undergo lymphatic metastasis, lymph node dissection is not required and only local excision is needed. 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 for poor prognosis. The current surgical treatment for gastric mesenchymal tumor is complete resection of the mass, avoiding tumor breakdown and preserving the function of the stomach as much as possible. With the improvement of simple gastroscopic peeling and resection, hemostasis, and wound closure techniques, more and more cases of small mesenchymal tumors have been resected by simple gastroscopy in recent years. To ensure safety, gastric mesenchymal tumors that are resected by endoscopy are generally small masses of less than 2CM. There have been many successful cases of endoscopic resection of masses larger than 2 cm, mainly those growing into the gastric lumen. To avoid injury to the mass during stripping, endoscopic total resection, which has been developed in recent years, can theoretically achieve the same results as surgery, but is technically demanding and cases should be carefully selected to ensure patient safety, as safety and long-term results are more important than minimally invasive. Laparoscopic surgery has been able to accomplish any partial or total gastrectomy of the stomach, with significant minimally invasive advantages while being safe. In 2 0 0 7, the National Comprehensive Cancer Network (N C C N) concluded that surgery is mandatory for gastric GIST over 2 c m based on clinical research evidence, and laparoscopic surgery can be performed for gastric mesenchymal tumors between 2 cm and 5 cm by removing a portion of the stomach. For gastric mesenchymal tumors over 10 cm in diameter, open surgery is generally used because even if the tumor is completely removed laparoscopically, a larger incision is required to remove the specimen intact (unlike gastric cancer, the mass is flat and can be bagged and removed through a small incision). The combination of gastroscopy and laparoscopy is currently the best method to treat gastric mesenchymal tumor, which can achieve precise localization and outline the minimum safe incision margin. The most common site for gastric mesenchymal tumors should be in the upper part of the stomach, close to the entrance cardia, and preserving as much of the gastric wall as possible is an important factor in ensuring postoperative gastric function. Tumors located in the posterior wall of the stomach and growing mainly into the lumen require intraoperative localization. Hospitals where the surgeon himself performs the endoscopic examination and treatment have a distinct advantage in assessing the suitability for endoscopic treatment alone and in performing combined endoscopic and laparoscopic treatment. There has been a pharmacological research milestone in the pharmacological treatment of mesenchymal tumors. in 1998 Hirota identified functionally acquired mutations in the GIST c-kit gene. the KIT protein product (CD117) is a highly specific marker for GIST. These research results are of great value for the exact determination of the clinical diagnosis of GIST, and also on the basis of this theory, molecularly targeted therapeutic drugs such as Gleevec and Sotan have been developed and applied to prevent recurrence after surgical resection or for the treatment of cases that can no longer be treated surgically, with very good results. When the tumor grows to a large size, although it can be surgically removed, it may affect the function of organs or other organs have to be removed in combination, you can consider applying targeted drugs first and wait for the tumor to shrink before surgery.