ObjectiveTo compare the efficiency and value of endoscopic submucosal tunnel dissection (ESTD) and endoscopic submucosal dissection (ESD) for early esophageal cancer and precancerous lesionsMethodsRetrospective study was performed in 30 patients diagnosed with early esophageal cancer and precancerous lesions from Jan. 2012 to Dec. 2014.Marking to complete dissection time(min)， resection area(cm2)， the resection rate per unit time (mm2/min)， the en-bloc resection rate， complete resection rate， bleeding rate， perforation rate and postoperative complication were analyzed in both groups.ResultsMarking to complete dissection time in ESTD ( 53.20±11.82） minwas shorter than that in ESD (74.20±21.64 min),(P＜0.05); resection area in ESTD (10.33±2.56) cm2 was obviously larger than that in ESD (7.19±4.12) cm2(P＜0.05); the resection rate per unit time in ESTD (20.17±5.89) mm2/min was bigger than that in ESD (9.80±4.81) mm2/min(P＜0.05).The max diameter in ESTD was longer than that in ESD\[(5.4±1.8 vs 3.8±1.6) cm\](P＜0.05).Both groups were different in sex and age (P＞0.05).The en-bloc resection rates in both groups were 100%.The complete resection rate in ESTD was 93.3% vs 86.7% in ESD.There were three patients bleeding during operation, hot biopsy forceps and/or hemostatic clips were used to stop bleeding.There was no delayed bleeding.Perforation happened in 1 patient (6.7%).No bleeding, perforation or mediastinum emphysema in ESTD.Stenosis appeared in five parents while three in ESD.ConclusionESTD and ESD are both valid measures for early esophageal cancer and precancerous lesions.However, ESTD should take precedence over ESD in large area lesion in esophageal diseases.ESTD has advantages of shorter operation time, higher dissection speed, larger dissection area.