Lymphadenectomy

Lymphadenectomy is the procedure through which the surgeon removes one or more lymph nodes from the body. Doctors may advise patients with gastric cancer, lung cancer, head and neck cancer, breast cancer and gastrointestinal cancer to undergo lymphadenectomy.

Lymphadenectomy has the following benefits:

• Remove the cancerous cells that may be present in the lymphatic system
• Determines the severity of cancer through grade and stage
• Accurate stage diagnosis helps develop an appropriate treatment strategy that may improve outcomes

Alternate Name

Lymphadenectomy is also known as lymph node removal procedure or lymph node dissection.

Body Location

Lymph nodes are a part of the lymphatic system of the body and can be found in various regions of the body, such as the underarms, neck, groin, abdomen and chest.

How Performed Lymphadenectomy

Lymphadenectomy is completed within one hour. The surgery is performed under general anaesthesia. The surgeon creates an incision on the skin over the area with affected lymph nodes. The surgeon removes the lymph nodes, lymphatic tissue, and underlying soft tissue from the nearby region. The surgeon then sends the removed nodes and tissues for evaluation for cancer. After the removal, the surgeon closes the incision with sutures and places a bandage over the wound. The patients are usually discharged on the day of surgery. However, if there is a complication, the patients may need to stay in the hospital for 1-2 days.

Preparation for Lymphadenectomy

• The surgeon may recommend stopping smoking and avoiding taking certain medications (e.g. blood thinners) before lymphadenectomy. 
• The surgeon advises the patient not to eat or drink from the night before the surgery. 
• The patient should inform the surgeon about the current medications. 
• The patient may be hospitalized one day before the day of surgery. The doctor may advise blood tests and imaging testing to determine if the patient is fit to undergo the procedure. 
• The staff may ask the patients to sign the informed consent. 
• The other preparations depend upon the site of lymph node removal. For instance, if the lymph node must be removed from the colorectal region, the doctor may recommend taking enemas to empty the bowels. 

Procedure Type of Lymphadenectomy

It is an invasive procedure that involves making an incision to remove the lymph nodes.

Follow-up

The surgeon recommends the patient visit the hospital for follow-up one week after the discharge. The surgeon shares the pathological result with the patients and discusses the further course of action in detail. The surgeon will also evaluate the wound and check for any infection. The patients should take a list of questions to discuss with the surgeon. If possible, the patient should bring friends or family members with him to understand more about the diseases and further treatment strategies. The surgeon may remove the drainage tube if the drainage is less than 30 cc for two consecutive days.

Risks

Like other surgical procedures, lymphadenectomy also has certain risks and complications. Some of them are:

• Numbness, pain, and infection of surgical wound
• Swelling and oedema in limbs
• Haemorrhage, pancreatic fistula, and bile duct injury may occur in lymphadenectomy for gastric cancer.
• Patients with over 14 retroperitoneal lymph node removals are at increased risk for developing deep vein thrombosis and wound dehiscence.

Recovery

It is necessary to keep the wound dry during the recovery period to reduce any risk of infection. The surgeon may also advise avoiding raising heavy weights until the patient is recovered completely. Avoid wearing jewellery and tight clothes to prevent rubbing the wound area. Always take the medication strictly as prescribed by the doctor. Consult with the doctor in case the patient experience severe adverse events after the surgery.