Abstract:Gastric cancer is one of the major diseases that pose a threat to the health of the Chinese people. After years of development and refinement, endoscopic submucosal dissection (ESD) has been recommended by multiple international and domestic guidelines and consensuses as the preferred minimally invasive treatment for early gastric cancer. Due to its advantages of minimal trauma, few complications, and rapid recovery, ESD has been promoted and developed in China. Based on the "Perioperative Guidelines for Endoscopic Submucosal Dissection of Gastric Lesions" published in 2017, and incorporating new evidence and perspectives that have emerged since the publication of the previous guidelines, we have organized experts in the fields of gastroenterology and pathology in China to update this guideline, aiming to provide a reference for perioperative management of ESD.