Abstract Objective: To ring for the treatment of mixed hemorrhoid surgery, most of the large presence of local damage, post-operative complications and other defects. Observed using different stripping tie ring mixed hemorrhoids surgical treatment efficacy, and to explore the anal sphincter function and circumferential mixed pathogenesis. Surgical techniques: the ring mixed hemorrhoids external hemorrhoids with the sub-stripping, ligation of internal hemorrhoids with injection of non-liquid Xiaozhiling area hemorrhoids ligation method. Circumferential mixed for varicose veins do not release the anal sphincter, and for circumferential mixed connective tissue type to give anal sphincter release. Results: 164 patients were cured and 158 cases, 96%, effective in 6 cases, accounting for 4% of all effective course of 12-21 days, an average of 16 days, one year after surgery follow-up, there are follow-up results of 156 cases, including two cases of occasional wet anus, itching, with no recurrence and secondary anal fissure, anal stenosis. Conclusion: The circumferential mixed connective tissue type of patients, the anal sphincter tension, poor flexibility, giving anal sphincter release surgery, after surgery can reduce pain, prevent local edema, but also to prevent anal stenosis after surgery. Circumferential mixed-type patients with varicose veins, the most lax anal sphincter, anal sphincter surgery does not release, it does not cause anal stenosis. Therefore, anal sphincter dysfunction and the pathogenesis of mixed hemorrhoid ring to be explored. Keywords circular mixed hemorrhoid ligation stripping anal sphincter injection Xiaozhiling