Postoperative taste and smell deficit after upper gastrointestinal cancer surgery--an unreported complication

Patients undergoing upper gastrointestinal cancer surgery were noted to suffer loss of taste and/or smell, a previously unreported problem. Our aim was to investigate the extent of this phenomenon, quantify recovery time, and identify potentially associated factors.

In this retrospective study, a postal questionnaire was sent to all patients still alive after oesophagectomy or gastrectomy, with a minimum 1-year follow-up and no clinical or radiological evidence of recurrence. Data were analysed for prevalence of deficit in relation to operation, age, sex, respiratory complications, and disease stage.

A total of 109/119 (92%) patients completed the questionnaire: 50 gastrectomies and 69 oesophagectomies. Ten patients were excluded with prior sensory deficit. Overall, 45/99 patients (45%) suffered deficit (M:F = 1.6:1). No association was found with type of surgery: deficits for subtotal gastrectomy, total gastrectomy, and oesophagectomy were 44, 46 and 46% respectively (chi(2) = 0.355, 2 df P > 0.5). No other parameter was associated, and full recovery occurred in 30 patients (67%) within a mean of 6 months.

Loss of taste and smell occurs in nearly one-half of all cases after upper gastrointestinal surgery. The pathophysiology is unknown, but it resolves in most patients within 6-12 months. This complication should be discussed as part of informed consent for patients undergoing oesophagogastric cancer surgery.