Mixed hemorrhoids need to be treated accordingly according to specific symptoms, investigations and personal circumstances, not all mixed hemorrhoids need surgical treatment, asymptomatic hemorrhoids do not need treatment, symptomatic hemorrhoids do not need radical treatment, conservative treatment, non-surgical treatment is the main focus. The indications for surgery for hemorrhoids are ineffective conservative treatment, more severe symptoms, larger fibrotic external hemorrhoids, etc. For internal hemorrhoids, generally 3rd and 4th degree internal hemorrhoids are indications for surgery. For inflammatory external hemorrhoids, thrombosed external hemorrhoids, and connective tissue external hemorrhoids, the decision is generally based on the patient’s main clinical symptoms. The following cases of mixed hemorrhoids require surgical treatment: I. Frequent episodes of bleeding in the stool, very large amounts of blood in the stool, or even anemia, which affects the function of the whole body, and the effect of conservative treatment is not obvious. Second, the hemorrhoid nucleus is large, the degree of prolapse is more serious, after the stool or walking are out of the anus, can not be returned by themselves, after using the hand to return again prolapse, or even can not be returned, long-term outside the anus. Third, the hemorrhoid is embedded outside the anus, cannot be returned, edema or the formation of thrombosis, accompanied by severe pain symptoms. Fourth, external hemorrhoids are large and often inflamed with swelling and pain.