From 2007 to 2008, the Department of Proctology of our hospital carried out surgical modification treatment of segmental ligation interval suture for some of the heavier circumferential mixed hemorrhoids, a total of 150 cases, all of which achieved satisfactory results, which are summarized as follows. 1. Clinical data 1.1 General data: 50 cases of severe circumferential mixed hemorrhoids, 87 men and 63 women, aged 26-76 years, with a maximum duration of 50 years and a minimum duration of 5 years. 1.2 Surgical method: Take a lithotomy position, routinely sterilize and lay sterile sheets. Lidocaine local anesthesia, then disinfect the rectal canal twice with iodophor, dilate the anus to make the hemorrhoid completely prolapse, clamp and lift the external hemorrhoid with tissue forceps to divide it into 6 equal-sized segments with 3, 7 and 11 points as equal points; suture the base of the hemorrhoid nucleus in the 3, 7 and 11 points segment with No. 10 silk thread, and ligate the external hemorrhoid in the shape of “8”, distal end of the suture line The hemorrhoidal tissue was cut at 0.3 cm. The interstitial hemorrhoids are lifted and unfolded in a transverse clamp and intermittently sutured with 000 absorbable thread while cutting, with a stitch spacing of 0.3 cm and a margin spacing of 0.3 cm. Treatment of other hemorrhoid nuclei in the anal canal: the site, number and size of the hemorrhoid nuclei are carefully identified, and they are sutured with 000 absorbable thread in a transverse “8” pattern. Long-acting anesthetic of methylene blue lidocaine was injected at the anal verge. One rubber tube was placed and pressure bandage was applied, and the operation was completed. 1.2 Postoperative treatment: the following day, warm water sitz bath, one tylenol plug anal plug. Keep the stool unobstructed. After 10 days, all nuclei of the ligated nevus fell off, and the patient was discharged from the hospital, and was instructed to continue the tylenol plug twice a day for one week. Telephone follow-up was recorded. 1.3 Postoperative reactions Pain can be tolerated and does not affect daily activities, individual patients with local anesthesia with lidocaine may experience postural hypotension symptoms (dizziness, nausea, vomiting), which can be relieved by lying in bed for 2 h after surgery, no special treatment is needed. A few may develop urinary retention and can urinate on their own with a warm water sitz bath. 1.4 Results (1) efficacy criteria Healed: no bloody stool, no hemorrhoid prolapse, atrophy of hemorrhoid nucleus, flat anal opening, no bulge during stool. Improvement: no bloody stool, no hemorrhoid prolapse during stool, atrophy of hemorrhoid nucleus on direct anoscopy, partial external hemorrhoid augmentation during stool. Ineffective: no significant change compared with before treatment. (2) Result: All of them were cured after 6 months to 1 year follow-up, and none of them recurred. 2. Discussion 2.1 The external hemorrhoid ligation method is to ligate the base of the hemorrhoid nucleus with a silk thread to produce ischemic necrosis of the nucleus. The advantage of this method is that it is easier to preserve the skin bridge and prevent the anal canal skin bridge and mucosal involution by slowly cutting the hemorrhoid nucleus with a wire instead of a knife; because of the slow cutting, the rich small blood vessels within the trauma of the two skin bridges can be embolized, which avoids postoperative bleeding and edema. The advantages of this method are the protection of the anal canal skin, less bleeding, small trauma, fast healing of the wound and less pain for the patient, which has been widely used. However, for severe circumferential mixed hemorrhoids after ligation, an oblique lateral incision of 1.5~2.0 cm outside the anal margin of the lower branch of the dentate line, including the lower part of the external sphincter skin and the lower end of the internal sphincter, is also required to prevent postoperative anal stenosis. This will inevitably result in damage to the anal sphincter and destruction of the anal shape, and will leave a large anal margin scar, and some patients will also suffer from sphincter insufficiency. The advantages of this modified procedure are: the external hemorrhoid can be completely removed, the skin bridge is adequate, the sphincter and the perianal skin are not cut, there is no surgical scar on the anal margin, the postoperative anal shape is complete, and the anal function is ensured. It is a safe and reliable surgical method. 2.2 For the treatment of internal hemorrhoids, there are methods such as sclerotherapy injection, ligation, suture ligation, freezing, laser, etc. We choose the transverse “8” suture ligation method for internal hemorrhoids, which plays the role of suspension of the anal cushion while treating internal hemorrhoids and prevents the ectropion of the anal canal mucosa.