Tobacco use may not alter histology of buccal mucosa harvested for urethroplasty: Study

The study, published in the journal Urology, found that although there exists clear evidence linking poor surgical wound healing and tobacco use, there is no apparent relationship between altered buccal mucosa histology and tobacco use.

Joshua Sterling, Department of urology, SUNY Upstate Medical University, Syracuse, NY, and colleagues conducted the study to assess the effect of tobacco use on oral mucosal tissue collected for urethroplasty.

For this purpose, the researchers conducted a retrospective histologic and immunohistochemical (IHC) evaluation of buccal mucosa tissue samples from patients who underwent buccal mucosa graft urethroplasty from 2018 to 2020. During pre-operative workup, the patients were queried about tobacco use. Counseling was provided to patients, and resources were given to aid in the cessation of tobacco use. Surgical cases were however not canceled or delayed if patients are not able to cease all tobacco use. Former users were those who ceased use 3 months prior to surgery.

The buccal mucosa specimens were evaluated for histologic changes by a single pathologist blinded to the smoking status. Quantitative IHC for Sox2 and p75 were obtained. Due to their clear and direct involvement in oral mucosa's regenerative mechanism, these investigative markers were selected. Comparisons were made between former tobacco users, current users, and control patients by the use of ANOVA and Chi-square analyses.

Key findings were as follows:

· Study cohort was 16 former users, 16 current users, and 32 controls. There was no difference in demographics across the groups.

· No differences were seen in blinded histologic analysis between all groups.

· Greater collagen density was found in the control group compared to current users in pair-wise statistical analysis.

· No differences were observed between former and current users or former users and controls.

· IHC analysis did not show any difference in the amount or localization of epithelial stem cell markers.

The researchers wrote in their conclusion, "our study of buccal mucosa did not find clear or clinically significant IHC or histologic differences between patients with a history of tobacco use and those without a history of use."

Reference:

The study titled, "Evaluation of the Effect of Tobacco Use on Buccal Mucosa Graft Histology," was published in the journal Urology.

DOI: https://doi.org/10.1016/j.urology.2022.03.038