PPH surgery is also called “anastomotic rectal mucosal circumferential resection and stapling”, which is based on the understanding of anal cushion doctrine and involves circumferential resection of the rectal mucosa 2-3cm above the dentate line and then stapling the upper and lower ends together “like a staple” to make The symptoms of prolapsed hemorrhoids are reduced or even disappeared. Since its introduction into China in the 1990s, it has been the subject of debate in the cutting-edge field of anorectology. Many scholars believe that it will be out of the anorectal field in a few years or a decade. The reasons are: 1. PPH is a rectal mucosal circumcision, which can only be performed on low rectal mucosal prolapse, simple internal hemorrhoids or mixed hemorrhoids mainly internal hemorrhoids, and it is not a cure for all diseases. 2, the cost is too high, beyond the affordability of the Chinese people. 3, there are many domestic treatment methods that only cost a fraction of its money to achieve better results than it. 4.The method has been introduced into China for a short time, and a series of complications have appeared. For example, postoperative complications such as hemorrhage (due to so many staples sticking in the anal canal, a circular stricture was formed, which was tricky to rescue) and anastomotic infection. Another finding from some reports is that some complications are quite serious and death is often reported. A number of experts in China have confirmed that some patients still have recurrence after surgery. Complications of PPH surgery are mainly: 1. Anastomotic stenosis: the main symptom is the difficulty of defecation or the feeling of unclean defecation after surgery, which requires dilator expansion, some of which can be relieved by several times, and some of which can be relieved by dozens of expansions for up to 2-3 months. In some cases, it is not effective at all. The patient is often in pain and sweating profusely during each 20-30 minute dilation. This is one of the more common complications. The reasons are: (1) The anastomosis is positioned high, the purse-string suture is too deep, injuring the muscle layer of the intestinal wall, and the purse-string suture is not in the same plane. (2) Too many sutures at too large a distance when dealing with anastomotic bleeding. (3) Postoperative edema and infection of the anastomotic tissue, if the dilator expansion is ineffective, if the stenosis is serious, it is necessary to perform longitudinal and transverse rectal suturing. (2) Tissue rejection due to postoperative staple exposure: the patient shows severe pain, and the staple is exposed under anoscopy, and there is local blood leakage for 2-3 days after forced removal. It is frightening that once one ligature is infected it will lead to rejection of all ligatures and must be removed one by one for about 40 days. Eventually a circular stricture of inflammatory connective hyperplasia forms, which after healing manifests as persistent difficulty in defecation. Characteristically, the stool varies from several to dozens of times per day, and the stool is mostly 1 cm in diameter and 2-3 cm in length with mucus cherry. The causes are: (1) unskilled surgical operation, nail exposure right after stapling, direct result of the rejection reaction. (2) Anastomotic stenosis, local cracking of the stenosis ring when the patient forcefully defecates, which causes the nail ligation to be exposed and causes the rejection reaction. (3) Partial residue of external hemorrhoids or prolapse of hemorrhoid nucleus, some hospitals, for the sake of economic benefits, perform PPH surgery on those mixed hemorrhoids with half of internal and external hemorrhoids or even external hemorrhoids as the main hemorrhoids, after which the patient still has the hemorrhoid nucleus prolapse outside the anus by squatting and defecating or some of the external hemorrhoids have obstructed venous reflux causing edema at the anal verge, forming larger thrombosed external hemorrhoids or extensive thrombosis in about 2-3 days. Patients suffer a lot of pain and no special treatment, and the psychological pressure is often the trigger for medical disputes after PPH surgery. 3, perianal abscess: its occurrence is closely related to the infection at the anastomosis. Once a perianal abscess occurs, it is difficult to deal with, and medical disputes are common for this reason. Reasons: (1) The anastomosis itself is an open wound, which is easy to be the route of infection. (2) If the anastomosis is partially bleeding, sutures need to be used, and the residual thread in the local area is another condition for infection. Treatment: If a perianal abscess has occurred, it should be quickly incised and drained to remove necrotic tissue. If the patient is afraid of blame, the use of conservative treatment will often result in unpredictable consequences. 4, pelvic infection: There have been many reports in China, which are serious complications of PPH surgery, and there are reports of death caused by postoperative pelvic infection. A hospital reported a case of severe pelvic and retroperitoneal infection occurred early after PPH surgery, the patient was a 24-year-old male, and serious infection occurred after PPH surgery despite the administration of antibiotics, CT suggested a large amount of retroperitoneal gas, and a quick dissection was performed, sigmoid colostomy and presacral drainage were performed, resulting in a serious medical accident. 5, post-operative recurrence: Because PPH has its own limitations, although the surgery removes part of the tissue, but does not solve its “anal cushion” continues to move down, it can still recur. Especially for those with larger hemorrhoids, loose mucosa and post-operative stenosis, many patients consulted online “I did PPH surgery only a few months how to relapse again?”