Surgery

Lymph Node Surgery

Terminology

Surgery to remove lymph nodes often goes under several different names such as

  • Lymphadenectomy - the correct medical term
  • Lymph node dissection

All of the terms refer to complete excision of all the lymph nodes in one region. Typically the groin, axilla (armpit) or neck.

What is involved?

Lymphadenectomy is a major surgery not to be taken lightly. It usually performed under general anaesthesia by a skilled surgeon who frequently performs the procedure since lymph nodes are situated next to important anatomical structures which must not be damaged.

The operation comes with a number of risks which must be discussed pre-operatively with the patient prior to agreeing consent.

Complications

Wound Healing can be difficult, especially following a groin node dissection. The groin is a moist and dirty area, regardless of your hygiene and is rich in bacteria translocated from the nearby genitals and anus. Wounds here easily become infected, something which is worsened by a cancer patients impaired capability to easily fight infection.

A seroma is common (especially in the groin and axilla) meaning a collection of lymph or tissue fluid in the lymphadenectomy cavity created. A seroma may require aspiration by syringe and needle on one or more occasions and can become infected, especially if there are healing difficulties. Particularly stubborn seromas may take months to resolve and in some cases the limb is plagued by chronic lymphoedema.

Lymphoedema is a serious and debilitating complication of lymphatic surgery. After the nodes are excised, lymph drainage of the limb is effectively blocked and the fluid cannot escape – resulting in swelling. There may also be secondary effects such as changes to the skin and infection. The extent of lymphoedema is variable, from a slightly swollen arm or leg to severe swelling. It can be treated by manual lymphatic drainage and compression garments.