Autolysis: A plausible finding suggestive of long ESD procedure time

Jong Jin Hyun, Hoon Jai Chun, Bora Keum, Yeon Seok Seo, Yong Sik Kim, Yoon Tae Jeen, Hong Sik Lee, Soon Ho Um, Chang Duck Kim, Ho Sang Ryu, Yang Seok Chae

    Research output: Contribution to journalArticlepeer-review

    2 Citations (Scopus)


    Autolysis is the enzymatic digestion of cells by the action of its own enzymes, and it mostly occurs in dying or dead cells. It has previously been suggested that prolonged procedure time could lead to autolytic changes from the periphery of the endoscopic submucosal dissection specimens. Recently, the authors have experienced a case of autolysis; due to the presence of ulcer, fibrosis, and frequent bleeding from the cut surface, it took 6 hours to complete the resection. More than halfway through the resection; bluish purple discoloration of the part of the dissected flap where the dissection was initiated was noticed. Histologic examination of this site showed diffuse distortion of epithelial lining and cellular architectures along with loss of cell components, compatible with autolysis. Because autolysis could theoretically pose a potential problem regarding the evaluation of resection margin, endoscopists and pathologists should communicate with each other for a reliable pathologic decision.

    Original languageEnglish
    Pages (from-to)e115-e117
    JournalSurgical Laparoscopy, Endoscopy and Percutaneous Techniques
    Issue number2
    Publication statusPublished - 2012 Apr


    • autolysis
    • endoscopic submucosal dissection
    • expanded indication

    ASJC Scopus subject areas

    • Surgery


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