ABSTRACT
To determine the effectiveness and safety of cryosurgery as an out-patient, minimally-invasive modality of treatment for chronic fissure-in-ana.Observational study.At Ankelseria Nursing Home. Karachi. from July 1999 to June 2003. Male patients of various age groups having chronic fissure-in-ano were treated. Basco and Spembly cryosurgical instruments and nitrous oxide gas were used. Probe was passed through proctoscope and applied to anal papilla, upper 1/3[rd], middle 1/3[rd], lower 1/3[rd] and skin tag in sequence for 1[1/2] to 2 minutes. Local anesthetics were used in selected cases having severe pain after the procedure. Out of 11 cases, cryosurgery failed in 3 patients [27.27%] because they had severe pain and underwent operation within 3 days. Eight patients [72. 72%] responded well to the treatment. Pain relief was 50% in 5 patients after 2 weeks: while after 4 weeks 4 had 50% relief and 7 had 75% relief After 8 weeks all 8 were free of pain. After 8 weeks ulcer was completely healed in 6 and partially healed in 2 cases. Anal papilla was eradicated completely in 3 and partially in 2. Skin tags completely disappeared in 3 and had no effect in 2 patients. Followup for 6 months showed complete pain relief and ulcer healing in all, except 3 cases. Cryosurgery is simple, safe, minimally invasive and effective modality of treatmentfor chronicfissure-in-ano