The idea of writing an order of consultation for gastrointestinal tumors has been a long time coming, and I have delayed writing it. When I saw some irresponsible doctors practicing for the sake of practice or other reasons of excessive medical treatment, I deeply felt the necessity of writing this article, such as: a patient, female, more than 50 years old, the lower esophagus has 1.5*1.5cm, 1~2 degrees of atypical hyperplasia. Hyperplasia is divided into light, medium and heavy three degrees; three degrees of severe atypical hyperplasia is also known as pre-cancerous lesions, pre-cancerous lesions must not be cancerous, does not belong to the category of cancer, local excision will not be a local recurrence will not be metastatic. According to the medical principle, after hospitalization, after appropriate preoperative examination and laboratory tests, the lesion (world endoscopy and domestic endoscopy standard) endoscopic mucosal resection of a large piece of the lesion, postoperative observation. The surgeon in this department however performed the first thoracoscopic esophagectomy, I wonder where his guts came from? So much so that he worked from 9am to 4pm. The total cost of more than 40,000 yuan, but also with gastric emptying obstacles, 11 days after the operation to be under the gastrointestinal nutrition tube, the final pathology confirmed only third-degree hyperplasia. And the total cost of mucous membrane stripping is only 3 or 4 thousand yuan, the key is small damage, the therapeutic effect is also commonly known as the prognosis, in the treatment of tumors and thoracoscopy and partial esophagectomy effect is identical, that is to say, you can completely achieve the purpose of resecting the lesion to avoid recurrence, and the endoscopic ESD its fast recovery and minimally invasive, with fewer complications, postoperative and preoperative patients feel no obvious discomfort is the esophageal resection can not be matched. endoscopic ESD is not comparable to esophageal resection. The following is a brief description of the order of treatment of digestive tract tumors. Firstly, for benign lesions of digestive tract, including esophagus, stomach, small intestine and large intestine, such as polyps, as long as they can be treated endoscopically, open chest or abdomen is not an option. Now for the larger atypical hyperplasia, can be endoscopically large mucosal dissection, we have carried out mucosal dissection diameter of 3.5 cm. there are also submucosal masses, such as smooth muscle tumors, in the past only to do the smaller free, and now there are scholars will be the esophagus, stomach, colon to do penetrating cuts when the removal of rupture of the titanium tongs clamping repair, close the fissure space, fasting, gastrointestinal decompression, anti-infective. This is also a new progress of endoscopic minimally invasive treatment. At present, doing small colonoscopy has not been popularized, while the morbidity of the small intestine is much smaller than other parts. Second: severe atypical hyperplasia, early cancer. Severe atypical hyperplasia is not yet cancerous; early cancer: cancer is located in the mucosa and submucosa, this kind of cancer has not infiltrated the muscle layer, as long as the endoscopic treatment, injection of water underneath the occupying area can make the mucosa and the muscle layer separate, the medical terminology is called the lifting sign is positive, then endoscopic resection can be done for the lesion in one piece. The specimen is sent to pathology, if the pathology shows no infiltration of the muscularis propria then this treatment is over, bulk case analysis and major surgical resection survival rate is not significantly different, that is to say, the same. If infiltration then additional surgery. If there are old and weak people who cannot tolerate surgery, radiotherapy and photodynamic therapy are also available. Thirdly, for advanced stage cancer, timely surgery can be performed when there is no obvious sign of metastasis, of course, according to the characteristics of cancer cytology, radiotherapy and/or chemotherapy can be used if the patient is not suitable for surgery due to old age and infirmity; for patients with advanced stage, all treatments are aimed at prolonging the life, and eradication of the disease is not possible. Under the premise of economic capacity can afford, for the primary foci, metastatic foci for intervention, treatment. Such as obstruction can be stent placement, local palliative chemotherapy drug injection, photodynamic therapy to make the tumor retraction to ensure that the digestive tract is open, so that patients can eat. Radiotherapy and other methods can shrink the lesion, reduce the patient’s consumption and prolong the life. Of course, such as traditional Chinese medicine drug treatment is no way out. Biotherapy carried out in recent years is also a supplementary choice. Therefore, how patients can choose the right treatment and successfully avoid overmedication is an issue that deserves careful consideration. Avoiding overmedication, on the other hand, should be the professional bottom line of every medical practitioner, so as to create a good space for patients to recover. Finding the right healer in the right place is the key to getting the right treatment.