Lymphadenectomy

What Is a Lymphadenectomy?

A lymphadenectomy is a surgical procedure for removing lymph nodes from the body. Also called lymph node dissection, this procedure is usually performed to evaluate evidence for the spread of cancer, which helps the medical team determine the progress of and treatment options for a patient’s malignancy. Lymphadenectomies target either some or all of the lymph nodes in a region close to the tumor, because they are the most likely to receive cancer cells through lymphatic drainage. A less-invasive alternative is called a sentinel node biopsy; it focuses only on the one or two lymph nodes closest to the tumor.

Lymphadenectomies are a critical tool in determining how best to fight this dangerous medical condition. If you or a loved one is concerned about cancer and is weighing treatment options, the oncologists and other caring professionals at Baptist Health can help.

Why Have a Lymphadenectomy? What Are the Benefits?

The lymphatic system is present throughout the body. Its proximity to many of the major organs makes patients with a wide range of cancers good candidates for a lymphadenectomy. Included are individuals with:

• Breast cancer
• Melanomas
• Head and neck cancers
• Differentiated thyroid cancers
• Lung cancer
• Gastric cancer
• Colorectal cancer.

There are three major types of lymphadenectomy. A modified or limited procedure concentrates on the lymph nodes closest to the source of cancer. A radical or total procedure removes all the lymph nodes from a particular region of the body (most commonly the armpit, neck, pelvis, or groin). An alternative form of surgery is called laparoscopy. A laparoscope is a narrow flexible tube with a light, camera, and surgical tools that is inserted through a small incision to the surgical site. The camera streams photos of the site to a computer screen. The surgeon uses the visual information on this screen to conduct the surgery. 

The benefits of a lymphadenectomy include:

• Post-surgical evaluation of lymphatic tissues for evidence of metastasis, that is, the spread of cancer beyond its point of origin
• Elimination of cancerous cells that have invaded the lymphatic system
• Determination of the cancer’s stage and grade
• Development of an effective treatment plan for an individual with cancer, based on a timely and accurate diagnosis.

A laparoscopic procedure has the additional benefit of being less invasive and quicker to heal than traditional wide-incision surgery.

Like all medical procedures, a lymphadenectomy carries with it certain risks. These include pain, infection, excessive bleeding, nerve damage, and phlebitis (inflammation of the veins). There is also a small chance of developing lymphedema, which is a chronic swelling of the area where the lymph nodes have been removed, due to a lack of fluid drainage and reduced immune response. There is currently no cure for lymphedema, and it is a frequent source of infection, but it is controllable by means of medical treatment.

How Do I Prepare for a Lymphadenectomy?

To prepare for a lymphadenectomy you should:

• Stop smoking beforehand, even if just for a few days
• Inform your physician of all current medications. He or she may ask you to stop taking some of them for a short while before the procedure (e.g., blood thinners such as aspirin). 
• Forgo solid food and liquids immediately prior to surgery.
• Prepare for the possibility of an inpatient stay by packing essentials and making arrangements with family or friends for transportation and visitation (if allowed).

What Should I Expect During a Lymphadenectomy?

Here’s what will happen on the day of the procedure:

• Arrive at the hospital or surgical center as instructed.
• A lymphadenectomy typically takes an hour and can be treated as an outpatient procedure. However, if complications arise, be prepared for an inpatient stay.
• You will be prepped for surgery and given a general anesthesia. You will be unconscious while surgery is performed.
• The incisions will be closed with sutures. These will disintegrate on their own or be removed at a later date by your surgeon.
• When you awake, you may find a tube inserted at the incision. This allows fluid drainage from the surgical site. 

After the procedure, you will be taken to a recovery room, where your vitals will be monitored. You may feel some pain. Members of your medical team will instruct you on how to care for yourself on returning home. You will be provided with prescriptions for any necessary pain medication and antibiotics.

How Do I Recover from a Lymphadenectomy?

At home you will need to:

• Keep the surgical site dry and clean. You’ll be able to bathe but may need to take precautions to keep the site from getting wet.
• The drainage tube will remain in place until drainage is complete. You will receive instructions on how to manage it.
• Protect the incision from cuts and sunburn. Don’t wear tight clothing or jewelry that might be a source of rubbing and infection.
• If swelling develops in your arms or legs, elevate them. Keep your physician informed of your current circumstances.
• The amount of pain will vary with the type of procedure you underwent. Take only doctor-prescribed pain medications; aspirin and other blood-thinning agents can lead to unwanted bleeding.
• Avoid lifting heavy objects until completely recovered.

An important part of your recovery will be the post-surgical visit with your physician. He or she will share the pathology report that was prepared, based on the analysis of the lymphatic tissues removed from your body. You will be able to discuss possible follow-up treatments, including hormone therapy, chemotherapy, targeted therapy, or radiation therapy.

Learn More About Lymphadenectomies at Baptist Health

The oncologists and other medical experts at Baptist Health are part of your frontline defense against cancer. Contact your Baptist Health provider today for questions or to schedule your appointment.