Abstract: Objective：To compare the efficacy and safety of endoscopic and surgical treatment for elderly singleearly early gastric cancer with extended indications of endoscopic submucosal dissection（ESD）.Methods：72 patients with elderly singleearly early gastric cancer treated by endoscopic surgery and 32 patients with early gastric cancer treated by surgery at the same time were respectively enrolled in the endoscopic group and the surgical group.Both groups met the expanded indications of ESD.The operation time，hospitalization time，residual lesions，recurrence，5year survival rate and complications were compared between the two groups.Results：The operation time，fasting time and hospitalization time of the endoscopic group were significantly shorter than those of the surgical group，and the hospitalization expenses were significantly lower than those of the surgical group（P<0.05）；the total incidence of shortterm complications in the two groups was close（P>0.05），but the total incidence of longterm complications in the endoscopic group was significantly lower than that in the surgical group（P<0.05）；the curative resection rate and the total resection rate of the endoscopic group were significantly lower than those in There was no significant difference in residual rate and recurrence rate（P>0.05）.The 5year complete survival rate and diseasefree survival rate were 100% （72/72）and 95.83%（69/72） in endoscopy group,respectively,while in surgery group were 96.88%（31/32） and 93.75%（30/32）,respectively.There was no significant difference between the two groups（P>0.05）.Conclusion：Endoscopic surgery forelderly singleearly early gastric cancer，which meets the expanded indications of ESD，has the advantages of short operation time，less longterm complications and quick recovery.

Key words: early gastric cancer, endoscopic submucosal dissection, surgery, complications, residual lesions