I published a paper on this subject several years ago regarding post-operative complications of PPH. In order to address the heavy questions of patients, a short summary is made to facilitate patients’ understanding. This article focuses on anastomotic bleeding. In the anorectal region, bleeding is the most common and major postoperative complication regardless of the procedure, and PPH surgery is no exception. After successful extraction of the firing anastomosis, the anastomosis often has jet bleeding, with an incidence of 36%-60% according to major domestic and international literature. The bleeding is firstly divided into primary bleeding within 24 hours after surgery and secondary bleeding in 3 to 10 days after surgery. I. Primary bleeding 1. Instrument factors: (1) Quality of the anastomotic nail: directly affects the quality of the anastomosis.? (2) The quality of the cutter: directly related to whether the tissue can be completely excised, if completely cut constantly or partially cut constantly, or cut off the tissue is not neatly will easily lead to anastomotic bleeding. Solution: In the first few years, there were more problems of this kind, but with the continuous renewal of the anastomosis, starting from Johnson & Johnson 03, the bleeding caused by the quality of the anastomosis has gradually decreased. 2, technical factors: the surgical skills and proficiency of the surgeon directly determine the quality of the anastomosis. (1) Excessive difference in tissue thickness in the same plane of cutting. (2) The operator does not have enough strength when striking the anastomosis or cannot complete the anastomosis at once. Solution: Improve the proficiency level to improve the quality of the anastomosis. (3) Vascular factors: The patient has more local vascular distribution or thicker vessels. Treatment: After the anastomosis is completed, use the favorable conditions of the anal dilator to carefully inspect the anastomosis with the help of suture ligatures, not only to make sutures to stop the bleeding point, but also to stop the bleeding point of suspicion with sutures at the same time. This method is completely different from the treatment of non-pulsatile bleeding points in traditional surgery. Second, secondary bleeding 1, the instrument factor and technical factor are equally present. Treatment: improve the quality of instruments and technical level, thus improving the quality of the anastomosis. 2.Infection factor: Infection makes the wound unable to heal as soon as possible, causing local tissue erosion and bleeding, or even causing local vascular erosion and necrosis and bleeding. Treatment: Effective prevention of postoperative infection through local drug changes, postoperative maintenance of cleanliness and infusion, etc. 3.Mechanical factors: Due to the temporary closure of the broken ends of the vessels on both sides of the anastomosis after surgery to form unstable thrombus, when external stimulation, such as: anastomotic nail loosening; mucosal atrophy on both sides of the broken end; stool rubbing the anastomosis to make the nail foot loose or mucosal hangings, etc., so that the broken ends of the vessels open again or the broken ends of the thrombus fall off, can cause bleeding. Treatment: Hemorrhoids are a vascular disease or a vascular-based disease, and surgical treatment of hemorrhoids is like a plumber who doesn’t turn off the water gate in repairing a faucet, water leakage is inevitable, and bleeding of varying degrees is inevitable after hemorrhoid surgery. A small amount of occasional bleeding can be treated without treatment; a small amount of continuous bleeding can be treated symptomatically, such as a hemostatic plug, hemostatic medication, or an epinephrine retention enema; a large amount of bleeding must be stopped by local sutures. The actual fact is that you can find a lot of people who have been in the business for a long time. I hope that my patient friends through these descriptions of my anorectal professional doctors to deal with post-operative complications of PPH can be understood, do not be afraid of the unknown, trust the doctor, believe that the post-operative accident is able to be solved through the efforts of doctors, so that you can recover health faster!