PPH literally translates directly: a method of treating rectal mucosal prolapse and hemorrhoids. The basic principle is to use a specially designed anastomosis to lift the prolapsed anal cushion by cutting the mucosa around the hemorrhoid for a week, so that the hemorrhoid no longer prolapses; at the same time, the hemorrhoid artery supplying the hemorrhoid is cut off, so that the hemorrhoid congestion is significantly reduced. PPH is not suitable for all hemorrhoids, its indications are: mainly Ⅲ, Ⅳ degree prolapsed internal hemorrhoids, and some patients with prolapsed rectal mucosa. The advantages of PPH: less pain; no anal deformation; short hospital stay. Disadvantages of PPH: high recurrence rate in the long term and serious complications can occur. The reported complications of PPH surgery include: lower abdominal pain or bradycardia or hypotension when the anastomosis is excited during surgery, postoperative rectal bleeding, rectal stricture, persistent postoperative pain, urgency of stool, transient anal incontinence and defecation, submucosal infection of the rectal anastomosis, rectovaginal fistula, and even life-threatening pelvic infection. With the promotion of PPH application, it has been used for 10 years in China. Now about the long-term follow-up of PPH, its long-term efficacy is not satisfactory, mainly because of the recurrence problem, and the recurrence rate is increasing with the extension of postoperative time. Problems and prospect of PPH: Analyzing the current situation of PPH treatment, the following problems need to be paid attention to: (1) PPH has narrow indications. It is used for severe cricoid prolapsed internal hemorrhoids, while other colorectal diseases should be excluded. The provisional specification of the Chinese Society of Anorectal Surgery Group on PPH treatment of hemorrhoids stipulates that the indications for PPH are Ⅲ and Ⅳ degree internal hemorrhoids with circumferential prolapse and Ⅱ degree internal hemorrhoids with recurrent bleeding. (2) Prevention and control of serious complications. Clutch hemorrhoid fixation is simple and easy to master, but there are still more complications in the application process, such as bleeding, pain, urinary retention, infection, rectovaginal leakage, etc. In addition, severe hemorrhage resulting in hemorrhagic shock has been reported. Although serious complications are isolated, they should be taken seriously enough. (3) High medical cost. Foreign studies have shown that due to the recurrence of hemorrhoids and hemorrhoidal symptoms after PPH, the reoperation rate is higher than that of the traditional procedure, thus increasing medical costs, and the medical costs of the PPH procedure itself are higher than those of the traditional procedure. (According to Longo, the advantages of PPH are that the normal structure of the anus is not destroyed, the patient suffers less pain, and the incision recovers in 3-4 d after the procedure, while recent studies by Greco and Hzboubi have shown that the anal cushion has lost its role due to chronic inflammation and fibrosis, even if the cushion is moved up through PPH. The role of the anal pad and the ability to control the bowel are lost even if the pad is moved up by PPH. In conclusion, recent and long-term studies on post-operative complications of PPH have shown that inappropriate application of PPH will lead to serious post-operative complications and high recurrence rate; the theoretical basis of PPH procedure needs to be verified by long-term clinical observation; therefore, the advantages of PPH procedure have to be judged by long-term follow-up and large sample of multicenter randomized controlled studies. From our clinical practice: 1 indications for PPH should be strictly limited; 2 the surgeon must have proven experience in using general anastomosis; 3 the advantages of PPH should not be blindly expanded while its disadvantages and complications should not be discussed. Therefore, conventional hemorrhoidectomy remains the main modality for the treatment of hemorrhoids.