OBJECTIVESTo explore the postoperative complications and efficacy of endoscopic resection of hypertrophic anal papillae combined with internal hemorrhoid ligation.METHODSA retrospective study was conducted on 47 patients from our center who underwent endoscopic resection of hypertrophic anal papillae, with or without internal hemorrhoids ligation. The patients were divided into two groups based on the surgical procedure: the anal papillae resection group and the anal papillae resection + internal hemorrhoid ligation group. The analysis included patient age, gender, anal papillae diameter, postoperative pain intensity and duration, postoperative bleeding severity, presence of anal edema, and follow-up outcomes at 3 months postoperatively.RESULTSThere were no statistically significant differences in age, gender, or anal papillae diameter among the two patient groups. The postoperative pain intensity was higher in the group undergoing anal papillae resection combined with internal hemorrhoid ligation, with a median Visual Analog Scale (VAS) score of 1 (0, 2), and the duration of pain was longer, with a median of 1 (0, 2) day. Both the pain intensity and duration showed statistically significant differences (P < 0.05). However, there were no statistically significant differences in the incidence of postoperative bleeding or anal edema. At the 3-month follow-up, the effective rates were 90.9% and 80.0%, respectively, and there were no statistically significant differences among the groups.CONCLUSIONThe complication rate of endoscopic resection of hypertrophic anal papillae combined with internal hemorrhoids ligation is low, and the therapeutic effect is good.