{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T05:08:19Z","timestamp":1775538499345,"version":"3.50.1"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Gastroenterol."],"abstract":"<jats:sec>\n                    <jats:title>Background and aims<\/jats:title>\n                    <jats:p>Hemorrhoids represent the most prevalent anorectal disorder globally. They are categorized into three types based on location: internal, external, and mixed hemorrhoids. Furthermore, internal hemorrhoids are classified from I to IV, depending on their appearance and degree of prolapse. Surgical intervention is frequently required for Grade III-IV and mixed hemorrhoids, which exhibit complex and severe symptoms. The challenges of these surgical procedures include extensive incisions, substantial intraoperative bleeding, intense postoperative pain, and a heightened risk of complications. Consequently, the exploration of alternative therapies continues.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This report introduces an innovative endoscopic technique employed to treat a female patient suffering from Grade IV hemorrhoids for three years. Utilizing an endoscope, the prolapsed hemorrhoid and hypertrophic anal papillae were progressively excised with a snare, followed by the application of a ligator to ligate the lax mucosa above the dentate line at multiple sites, thereby preventing future prolapse.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The procedure resulted in minimal bleeding, reduced postoperative pain, a shorter recovery period, and the patient experienced no complications such as anal stenosis or recurrent prolapse during the 8-month follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This technique is particularly innovative as endoscope facilitates a clearer surgical view and more precise manipulation, thus minimizing damage to the rectal mucosa and anal skin. Furthermore, this technique can be utilized to concurrently remove hemorrhoids during gastrointestinal endoscopy, which will alleviate the patient\u2019s multiple suffering and save money and time. This method offers a new direction for treating Grade IV hemorrhoids. Longer follow-up periods and larger sample size comparative studies are needed in the future to verify its safety and efficacy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fgstr.2026.1681972","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T04:25:32Z","timestamp":1775535932000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Endoscopic anal papillectomy combined with ligation: a new approach for the treatment of grade IV hemorrhoids (with video)"],"prefix":"10.3389","volume":"5","author":[{"given":"Xiaopan","family":"Lv","sequence":"first","affiliation":[{"name":"School of Clinical Medicine, Shandong Second Medical University","place":["Weifang, Shandong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mingli","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Weihai Central Hospital","place":["Weihai, Shandong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xianzhong","family":"Zeng","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, The People\u2019s Hospital of Linyi","place":["Linyi, Shandong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zheng","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Jinluo Hospital","place":["Linyi, Shandong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaitong","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Jinluo Hospital","place":["Linyi, Shandong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xuemin","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, The People\u2019s Hospital of Linyi","place":["Linyi, Shandong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(90)90828-o","article-title":"The prevalence of hemorrhoids and chronic constipation. 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