Abstract: Objectives To investigate the effectiveness of actively select the pull force anastomosis for procedure for prolapse and hemorrhoids (PPH) in treating severe hemorrhoids. Methods We retrospectively analyzed 92 patients with severe hemorrhoids treated by author,between January 2020 and January 2023.The 92 cases were randomly divided into control group and observationgroup,with 46 cases each group.The control group was treated with regular PPH,while the observation group was treated with actively select the pull force anastomosis for PPH.We compared the surgical parameters,clinical effectiveness,postoperative complications in the two groups.Results There was no significant difference in length of hospital stay,intraoperative hemorrhage,postoperative bleeding,postoperative anorectal sensation abnormalities(P＞0.05).The operation time(25.8±6.4)min,intraoperative submucosal hematoma 2.17%,the width and integrity of rectal mucosa (3.4±0.46) cm,the retraction of hemorrhoids with grade Ⅲ and grade Ⅳ(96.77%、88.67%) in the observation group were better than control group(P<0.05).The pain scores of the observation group at 24h,48h,7 day was significantly lower than that of the control group(P<0.05). Conclusion Actively select the pull force anastomosis for PPH has favorable effectiveness for severe hemorrhoids.The effect of anal cushion lifting was satisfactory,the retraction rate of hemorrhoids was high,the occurrence of submucosal hematomas was small,and the postoperative pain was light.

Key words: actively select the pull force anastomosis, procedure for prolapse and hemorrhoids, severe hemorrhoids