Objective To study the efficacy of four endoscopic therapies in the treatment of subcutaneous tumor of gastrointestinal tract. Method 308 cases with subcutaneous tumor of gastrointestinal tract that were treated with differ-ent endoscopic therapies were included in the study, patients were stratified as EMR group, ESE group, ESD group, and EFR group as per respective endoscopic therapy, of which the tumor origin, diameter, radical resection rate and successful resection rate, incidences of postoperative complications, recurrence, postoperative pathologic and immunohistochemical findings of the four groups were compared. Result The tumor origin were muscularis propria, submucosa and muscula-ris mucosa in the EMR group, and were muscularis propria, submucosa in ESE group, and in ESD group, tumors were mainly originated from submucosa and mucosal muscularis, while all tumors in EFR group were originated from the mus-cularis propia, with significant difference observed in regard of the distribution (P<0.05);The minimum tumor diameter was observed in EMR group at (0.68±0.06) cm, and EFR group had the maximum diameter at (2.08±0.53) cm, and the av-erage tumor diameter of the four groups were of significant difference (P<0.05); The radical resection rate in the four groups, were no significant difference (P>0.05);And the successful resection rate was 100%in EMR, ESD, and EFR group, higher than that in ESE group at 94.87%(P<0.05);The overall incidence of postoperative complications in EFR group was 100.00%, higher than that of ESE, ESD, and EMR group at 5.13%, 7.69%, and 0.00%, respectively, besides, the incidence rate in ESE (5.13%) and ESD group (7.69%) was also significantly higher than that of EMR group (0.00%) (P<0.05). All patients were followed up for 1 year, and no recurrence was observed. In postoperative pathologic and im-munohistochemical assay, it was found that the leiomyoma was of the highest incidence at 71.75%. Conclusion Endo-scopic surgery is minimally invasive in the treatment of subcutaneous tumors of gastrointestinal tract, with fast recovery, and low incidence of complications, specific endoscopic therapy can be considered based upon the tumor origin.%目的：研究不同内镜术治疗消化道上皮下肿瘤的临床疗效。方法选取接受内镜术治疗的308例消化道上皮下肿瘤患者为研究对象，按照内镜术式将其分为内镜黏膜切除术（EMR）组、内镜黏膜挖除术（ESE）组、内镜黏膜剥离术（ESD）组、内镜全层消化道壁切除术（EFR）组。比较4组患者的肿瘤起源、肿瘤直径、一次完整切除率及切除成功率、术后并发症、复发情况、术后病理或免疫组化情况。结果 EMR组肿瘤起源于固有肌层、黏膜下层、黏膜肌层，ESE组肿瘤起源于固有肌层、黏膜下层，ESD组肿瘤起源于黏膜下层、黏膜肌层，EFR组肿瘤全部起源于固有肌层，各组肿瘤起源部位分布差异有统计学意义（P﹤0.05）。EMR组平均肿瘤直径最小，为（0.68±0.06）cm；EFR组平均肿瘤直径最大，为（2.08±0.53）cm；4组患者平均肿瘤直径大小差异有统计学意义（P﹤0.05）。4组患者肿瘤一次完整切除率比较，差异无统计学意义（P﹥0.05）；EMR组、ESD组和EFR组切除成功率均为100.00%，高于ESE组切除成功率（94.87%），且差异有统计学意义（P﹤0.05）。EFR组术后总并发症发生率（100.00%）均高于ESE组（5.13%）、ESD组（7.69%）和EMR组（0.00%）；ESE组和ESD组术后总并发症发生率（5.13%和7.69%）均高于EMR组（0.00%），差异均有统计学意义（P﹤0.05）。各组患者术后均随访1年，均无复发情况。术后病理或免疫组化检查结果显示，平滑肌瘤发生率最高，为71.75%。结论内镜术治疗消化道上皮下肿瘤具有创伤小、术后患者恢复快、并发症发生率低等优点，可按照患者的肿瘤起源情况选择相应的内镜术进行治疗。
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