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BACKGROUNDS EFR was first described by Suzuki, H.in 2001 and applied in early cancer BACKGROUNDS——animal experiments BACKGROUNDS——animal experiments Kaehler, G did another experiment using a flexible stapler ,which showed pig esophagus is not possible for EFR with stapler due to insufficient lumen diameter.but justified its feasibility and safety in stomach.And subsequently applied in two patients stomach, one with early cancer and one with a carcinoid tumor ,whose specimens up to 4 cm × 4 cm in size.