Neither the diagnosis and treatment routine nor the nursing routine for hemorrhoids mentions what position the patient should take after endo-external debridement. It is usually believed that in order to reduce or avoid postoperative anal pain, bleeding, urinary retention and other complications, patients should brake from static and avoid sitting from lying down after surgery. As for the management of postoperative complications of mixed hemorrhoids, in addition to emphasizing the importance of surgical operation, the main focus is on the internal and external use of various drugs, hoping to use the effect of drugs to alleviate or reduce postoperative complications, while there is less research on whether the choice of postoperative position has an effect on postoperative complications. In this study, we observed the effect of different positions on postoperative complications in patients after internal ligation and external peeling of mixed hemorrhoids, and the results are summarized and reported as follows. 1. Data and methods 1.1. Case selection The diagnosis of mixed hemorrhoids was in accordance with the criteria of the “Guidelines for the clinical management of hemorrhoids (draft)”, the main clinical manifestations were the co-existence of symptoms of internal and external hemorrhoids, and the proposed mixed hemorrhoid internal ligation and external peeling was performed. In addition to other anal diseases, such as anal fissure, anal fistula, rectal tumor, etc. 1.2, General data All 200 cases were patients admitted to the Department of Anorectology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine from October 2009 to August 2010, and were randomly divided into an observation group and a control group of 100 cases each. In the observation group, there were 48 males and 52 females; the mean age was (48.2±5.12) years. In the control group, there were 46 males and 54 females; the average age was (47.16±6.73) years. The differences in age and gender between the two groups were not statistically significant (P>0.05) and were comparable. 1.3, treatment method The two groups were operated uniformly by internal ligation and external peeling of mixed hemorrhoids, and the daily red oil cream was changed routinely after the operation. 1.3.1.Observation group: 6h postoperatively, they were in the telescopic position for 30min each time, accumulating 2h per day; from the first day to the seventh day postoperatively, they were in the telescopic position for 4h per day, accumulating 30min each time. 1.3.2.Control group: On the day of surgery, they were in the recumbent position, and from the first day to the seventh day postoperatively, they were in the recumbent position (avoiding telescoping) during non-sleeping time, with unlimited posture. 1.4, Observation method 1.4.1, Clinical observation The 4-grade method was used to observe the symptoms of bleeding, pain, difficulty in defecation and difficulty in urination, which were evaluated on the day after hemorrhoid surgery and on the 3rd and 7th days after surgery (see Table 1 for grading criteria), and the length of hospitalization and time to return to work were also counted. 1.4.2, Clinical efficacy The clinical efficacy was evaluated on the 28th day after surgery with reference to the relevant standards [3]. Cured: symptoms disappeared and hemorrhoids disappeared; improved: symptoms improved and hemorrhoids shrunk; not cured: no change in symptoms and signs. 1.4.3, Follow-up Local discomfort and satisfaction with surgery were followed up 6 months after surgery. 1.5, Statistical methods Grade data were analyzed by Ridit, and t-test was used for measurement data. 2, Results 2.1, Comparison of clinical efficacy There was no statistically significant difference between the clinical efficacy of the observation group and the control group (P>0.05). 2.2, changes in clinical symptoms Pain and difficulty in urination were significantly lighter in the observation group than in the control group on the postoperative day (P<0.05); on the third postoperative day, complications such as pain, difficulty in urination, difficulty in defecation, bleeding and edema were significantly lighter in the observation group than in the control group (P<0.05, P<0.01); on the seventh postoperative day, complications such as pain, difficulty in defecation and bleeding were significantly lighter in the observation group than in the control group (P <0.05, P<0.01) . No complications such as anal stenosis occurred in both groups. 2.2 Comparison of hospitalization and return to work The average hospitalization time was (6.75 ± 1.28) days in the observation group and (10.28 ± 3.65) days in the control group; the difference was statistically significant (P < 0.01); the return to work time was (8.12 ± 2.73) days in the observation group and (14.28 ± 2.98) days in the control group; the difference was statistically significant (P < 0.05). The difference between the groups was statistically significant (P < 0.05). 2.4. Follow-up 42 cases in the observation group and 45 cases in the control group completed the follow-up 6 months after surgery, and the differences in local discomfort and satisfaction with surgery between the two groups were not statistically significant (P>0.05). 3 , Discussion Surgery is one of the important means of hemorrhoid treatment, and common postoperative complications include urinary retention, pain, bleeding, and difficulty in defecation. Trauma is an important factor in the development of inflammation, and the wound debridement process for open contaminated wounds is usually 7 days. During the inflammatory response period (7 days) of open hemorrhoid surgical incisions, the trauma site becomes congested and edematous due to increased capillary permeability and tissue exudation, while trauma pain is caused by increased intra-tissue pressure and the release of bradykinin and other peptides. For this stage of trauma, the improvement of local blood supply can reduce the congestion and edema at the trauma site, and also reduce the pain by decreasing the concentration of local inflammatory mediators. From an anatomical point of view, the sitting position does not aggravate pain at the patient’s surgical site. The anal canal is partially hidden in the perineal triangle, and when sitting in the end position, the weight is borne by the sciatic tuberosity and the fat and fascial tissues attached to its surface rather than the anus, so the end position does not compress the trauma. Secondly, the blood supply to the skin and subcutis of the anal canal mainly comes from the anal artery that crosses the internal and external sphincter to reach the corresponding area, so as long as the anal area is kept sufficiently relaxed, sufficient local blood supply can be ensured; at the same time, the venous return flow corresponding to the eponymous artery also needs to cross the sphincter to enter the body circulation. If the anal sphincter is continuously tense, it will compress the blood vessels that pass through it, affecting both the local blood supply and impeding the return flow of tissue fluid, thus aggravating the inflammatory response. Postoperative urinary retention is mostly due to excessive postoperative mental tension or sphincter spasm caused by painful postoperative anal wound stimulation, resulting in difficulty in urination due to spasm of the sphincter muscles of the bladder and urethra. Difficulty in defecation after surgery is mostly caused by the patient’s fear of defecation and the inability of the dilator muscle to relax causing secondary outlet obstruction type of defecation difficulty. Adopting a sitting posture can not only relax the anal canal sphincter to reduce the tension of the anal canal, increase the local blood supply and improve the local circulation, thus reducing the intensity of inflammatory reaction and lowering the postoperative anal pain; but also relieve the spasm of the urethral sphincter, thus reducing the occurrence of urinary retention, and the relaxed anal canal can reduce the patient’s downward sensation due to the local inflammatory reaction, alleviate unnecessary excess bowel movements and facilitate the evacuation of feces. The results of this observation showed that the difference in clinical efficacy between the two groups was not statistically significant (P>0.05), suggesting that the postoperative telescopic position had no effect on the efficacy of the operation. The observation group was significantly better than the control group in improving complications such as pain, difficulty in urination, difficulty in defecation, bleeding, and edema (P<0.05, P<0.01), and the hospital stay and return to work time were also less than those of the control group (P<0.05, P<0.01), suggesting that the telescopic position is beneficial to alleviate postoperative complications and patient recovery. The results of this study suggest that the end-sitting position of patients early after hemorrhoid surgery is beneficial to postoperative recovery and can effectively reduce and mitigate the occurrence of postoperative complications of hemorrhoids caused by surgical trauma.