The modern concept of anal cushions, hemorrhoids and hemorrhoids has been known and studied for thousands of years, but there are still many debates about the nature of hemorrhoids. In 1963, when Stelzner studied the anatomy of the anal canal, he found that there was a rich rectal cavity consisting of blood vessels, smooth muscle (Treitz muscle), elastic fibers and connective tissue under the mucosa of the anal canal, which was later called the “anal vascular cushion” by Thomson. “This structure is similar to the erectile tissue of the human body and can contract and expand as needed to assist the anal sphincter in controlling stool, which is closely related to the fine control of stool in the human body. When hemorrhoids are combined with bleeding, prolapse and pain, they are called “hemorrhoids”. As the modern concept of anal cushion, hemorrhoid and hemorrhoid disease is widely recognized, many surgeries and techniques to preserve the anal cushion have emerged in recent years. 2, hemorrhoids treatment principle According to the modern concept of hemorrhoids, the principle of hemorrhoids treatment is to treat the symptoms of hemorrhoids rather than the root cause of hemorrhoids themselves, so “treating hemorrhoids when you see them” is obviously a misconception that needs to be corrected. The modern view is that asymptomatic hemorrhoids do not require treatment, but only if they are combined with prolapse, bleeding, impaction and thrombosis. The goal of treatment for symptomatic hemorrhoids is to eliminate or relieve symptoms, not to cure the pathologically altered anal cushion. Surgery may be considered after conservative treatment has failed. Surgical treatment should be done without destroying or with minimal destruction of the anal cushion tissue. marino has pointed out that it is important not to treat signs without anal symptoms, and not to treat symptoms without anal signs. 3.Surgical treatment of hemorrhoids Surgery is one of the most important means of treating hemorrhoids. Surgery is required for internal hemorrhoids of III and IV degrees, acute hemorrhoids, mixed hemorrhoids, and external hemorrhoids with significant symptoms and signs. The surgical methods are Milligan-Morgan (M-M surgery) surgery i.e. open vascular cushion removal, submucosal hemorrhoidectomy (Parks surgery), circumferential hemorrhoidectomy (Whitehead surgery), suprahemorrhoidal mucosal loop (PPH surgery) and selective suprahemorrhoidal mucosal stapling (open loop PPH), but each procedure has its own advantages and disadvantages. 1, M-M surgery as a classic surgical approach, the removal of the vascular cushion itself, the treatment effect is good, but the postoperative pain and other complications occur at a higher rate. 2.Parks surgery preserves the sensory function of the anal canal mucosa and reduces postoperative pain, which seems to be superior to M-M surgery. 3.Whitehead surgery has existed for more than 200 years as a surgical procedure for the treatment of cricoid hemorrhoids, but the procedure completely destroys the mucosa near the dentate line and has a high incidence of mucosal ectasia and incontinence after surgery, and has not been used much in recent years. The development of the anal cushion theory has led to a change in the concept of hemorrhoid surgery, and the rise of suprahemorrhoidal mucosal circumferential hemorrhoidectomy (PPH surgery) since the 1990s is one of the important advances in hemorrhoid treatment. The procedure was first proposed and used by Dr. Longo in Italy, and its central technique is to remove the mucosa 2-4 cm above the tooth line, which allows the anal cushion to move upward, acting as a suspension of the anal cushion and significantly relieving the symptoms of prolapse. The procedure is popular worldwide for its advantages such as painless postoperative period, simple surgical operation and no anal incontinence, and the success of this procedure is also a wonderful interpretation of the theory of downward movement of hemorrhoidal anal cushion. Most scholars believe that PPH surgery is simple, with few postoperative complications, easy postoperative treatment and quick recovery work. In recent years, on the basis of PPH surgery, open-loop PPH, i.e. selective suprahemorrhoidal mucosal stapling, has been carried out, which inherits the concept of PPH and reduces unnecessary tissue damage, with less postoperative discomfort, and is increasingly popular among patients.