由於內視鏡技術的發展和大便潛血篩檢的普及，國內早期腸胃道腫瘤(Early gastroinstestinal tumor) 偵測率有逐年提高的趨勢。目前對於早期腸胃道內視鏡治療除了傳統的息肉切除術外，主要還有內視鏡黏膜切除術(Endoscopic mcosal resection, EMR)和內視鏡黏膜下剝離術(Endoscopic submucosal dissection, ESD)。和傳統腸胃道手術比較，經內視鏡腫瘤切除可以不需全身麻醉、減少住院天數、保留腸胃道完整的功能進而使病人有較好的生活品質、以及減少醫療支出。近年來有許多不同種類的內視鏡及其器械如電刀的發展，可以減少內視鏡腸胃道腫瘤切除的併發症如出血及穿孔等。現今在食道主要應用在侷限於黏膜且沒有淋巴轉移的早期腫瘤、貝瑞氏食道併有表皮異生(Barrett’s esophagus with dysplasia) 或原位癌(carcinoma in situ)；在胃方面主要應用在侵犯黏膜第一層以上且分化良好的腫瘤，因為其淋巴轉移的機率較小；在十二指腸方面主要應用在壺腹附近的腺瘤或息肉；在結腸方面主要應用在沒有淋巴結轉移的黏膜腫瘤。如果加上更有效的內視鏡幫助篩檢如色素染色內視鏡(chromoendoscopy)、放大內視鏡(magnifying endoscopy)、窄頻光頻影像(narrow band imaging)、螢光染色內視鏡(auto-fluorescence image, AFI)， 雷射共焦顯微內視鏡(laser scanning confocal microscopy)，相信對於腸胃道腫瘤的篩檢及治療會有更長足的進展。

Due to the stool occult blood test survey in Taiwan and improvement of technique of endoscopy, the detection rate of early gastrointestinal cancers is increasing in recent years. Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are used for resection of the early cancer without surgical intervention. Comparing to traditional surgical resection, these techniques are safer and less invasive. By the way, the total medical cost is less than surgery. The duration of admission is shorter and the quality of life is also better via endoscopic resection. Lots of developed apparatuses and methods are developed to prevent the complication including bleeding and perforation. There are individual indications of endoscopic resection in different parts of gastrointestinal tract. In esophagus, the ESD is used for the early tumor which is only localized in mucosal layer without lymph node involvement, Barrett’s esophagus with dysplasia, and esophageal carcinoma in situ. In stomach, the well differentiated gastric cancer with localized to submucosal layer 1 (SM1) is the indication. The endoscopic resection is mainly used in the peri-ampullary adenoma or polyp removal in the duodenum. The tumor larger than 20 mm in the colon without submucosal invasion or lymph node metastasis may be removed completely via ESD. As the improvement of endoscopic screening methods including chromoendoscopy, magnifying endoscopy, narrow-band endoscopy, auto-fluorescence image, and laser scanning co-focal microscopy, we are able to detect more and more early gastrointestinal tumor and predict the depth of tumor invasion. Tumor removal via endoscopy may be an efficient and safe technique.