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目的:介绍内镜肌层间剥离术（EID）这一新技术应用于早期直肠癌诊断性切除的经验，并分享其术后垂直切缘情况。方法:2024年1月26日，对1例70岁男性早期直肠癌（cTNM：T1~2N0M0）患者开展了内镜肌层间剥离术。肿物位于直肠左前壁距肛缘9 cm，直径20 mm。内镜肌层间剥离术包括以下6个步骤：（1）黏膜切开；（2）黏膜下剥离；（3）浅肌层切开；（4）肌层间剥离；（5）肿物完整切除；（6）创面处理。剥离速度为2.68 mm 2/min，手术全程为109 min。 结果:术后第5天顺利出院，内镜术后病理为pT1b，垂直切缘阴性。术后随访1月余，恢复良好，无出血、穿孔、感染或狭窄等并发症发生；肠镜结果提示见增生物，活检病理提示炎性肉芽组织形成。结论:EID应用于早期直肠癌诊断性切除的安全性尚可，且可获得垂直切缘阴性结果。

Objective:This report presents the initial outcomes of endoscopic intermuscular dissection (EID), a novel technique introduced by our team for the diagnostic resection of early rectal cancer, focusing on the postoperative status of the vertical margins.Methods:On January 26, 2024, a patient with early rectal cancer (cT1-2N0M0) underwent Endoscopic Intermuscular Dissection. The EID procedure consists of six steps: (1) mucosal incision; (2) submucosal dissection; (3) superficial muscular layer incision; (4) intermuscular dissection; (5) complete tumor removal; (6) wound management.Results:The patient was a 70-year-old male with rectal cancer (cT1-2N0M0). The tumor was located on the left anterior wall of the rectum, approximately 9 cm from the anal margin, and measured 20mm in size. The dissection rate was 2.68 mm2/minute, and the total duration of the surgery was 109 minutes. The patient was successfully discharged on the fifth day after surgery. Pathological examination of the post-endoscopic surgery specimen revealed pT1b, with negative vertical margins. Follow-up after more than one month showed good recovery with no complications such as bleeding, perforation, infection, or stricture occurring. Colonoscopy indicated the presence of a granulation tissue suggestive of inflammation.Conclusion:Endoscopic Intermuscular Dissection for the diagnostic resection of early rectal cancer is potentially safe and may achieve negative vertical margins.