Lymphadenectomy is the surgical removal and dissection of lymph nodes. It’s an important part of cancer staging and treatment. Analyzing lymph nodes for signs of cancer can help your doctor determine if your cancer is spreading (metastatic). It can also help stop it from spreading further.
A lymphadenectomy is a surgical procedure to dissect and remove lymph nodes. Lymph nodes are glands in your lymphatic system, a network of vessels, tissues and organs that operates throughout your body. Your lymph nodes’ job is to filter lymphatic fluid (called lymph) and remove damaged cells and cancer cells. A lymphadenectomy looks for evidence of cancer in your lymph nodes.
When healthcare providers recommend a lymphadenectomy, it’s usually for someone who’s already been diagnosed with cancer. Dissecting the lymph nodes in the region of the tumor is a way of discovering whether cancer has spread beyond the tumor (metastasis). This is part of the cancer staging process. Staging helps healthcare providers determine the best treatment approach.
Lymphadenectomy (lymph node dissection) is recommended for people diagnosed with certain types of cancer that can spread to lymph nodes. As your lymphatic system is one of the main pathways cancer spreads through, a nearby lymph node is the most likely place it would spread to first. Dissecting and analyzing a few nodes can help reveal how far it has spread into your lymph system.
Lymph node dissection is simultaneously a diagnostic procedure and a treatment. If your surgeon finds cancer cells in the lymph nodes they dissect, you can be assured that those cancer cells were removed in the process. Finding cancer there will also prompt your surgeon to look further and remove more lymph nodes if necessary. Removing the affected lymph nodes stops the cancer from spreading.
Conditions that most commonly benefit from lymphadenectomy include:
The two main types are “regional” and “radical.” A regional (or “selective”) lymphadenectomy removes a sample of the lymph nodes local to the tumor. A radical lymphadenectomy (also called “complete” or “total” lymphadenectomy) removes all the lymph nodes in that region.
Sometimes, surgeons begin by dissecting a single lymph node nearest to the tumor and checking to see if it has cancer. This is called a sentinel node biopsy. If this node does have cancer, your surgeon may want to remove additional nodes to check them, too.
Lymph nodes are located in clusters throughout your body. A lymphadenectomy targets one of these clusters, based on where your cancer is located. Certain cancers tend to spread through predictable pathways, beginning with certain lymph node clusters. Each cluster has a name. Your surgeon will target those lymph nodes and dissect one, some or all of them if necessary to screen for cancer.
You may have a lymphadenectomy at different points in your cancer treatment process. It may be an early diagnostic procedure before beginning treatment, or it may be part of a larger operation to remove a tumor. You may also have one after completing a course of cancer therapy, such as radiation therapy or chemotherapy, to check and make sure the cancer is all gone.
Your healthcare provider will likely run some initial tests to check out your lymph nodes before scheduling a lymphadenectomy. They may try to visualize them with radiology first, to see if they look swollen or abnormal. They may also begin with a fine needle biopsy or a core needle biopsy to look for evidence of cancer in one node. If these tests appear positive, they’ll investigate further with a lymphadenectomy.
You may have a lymphadenectomy through open surgery or laparoscopic surgery. Some medical centers may even perform a laparoscopic lymphadenectomy with robotic assistance. Laparoscopic and robotic surgery are minimally invasive techniques that allow surgeons to operate through small “keyhole” incisions. The method your surgeon uses will depend on the procedure and your overall condition.
A standalone lymphadenectomy is a relatively minor procedure that takes about an hour in the operating room. You’ll be asleep under general anesthesia for the operation. If you have open surgery, your surgeon will open the area with one incision. If you have laparoscopic surgery, your surgeon will use several small incisions. They’ll insert a camera into one and operate through another.
Your surgeon will remove the target lymph nodes and sometimes some of the surrounding tissue. They’ll send these samples to the lab to dissect and analyze for cancer. They’ll place a tube attached to a pouch inside the surgical wound before closing it. This is called a drain. It helps prevent fluid from collecting in the tissues. It will stay in place for a few days to weeks after your operation.
If you had a standalone laparoscopic lymphadenectomy, you’ll likely be able to go home the same day. If you had open surgery or a larger procedure, you may need to stay in the hospital for one to three days. Your healthcare team will let you know how to care for your wound at home. You may have to come back in a week or two to have your drain or stitches removed and receive your biopsy results.
Most people have mild pain during their recovery and manage well with over-the-counter medications. Some people have longer-lasting pain and stiffness in the area where their lymph nodes were removed, especially in their neck, shoulders and armpits. Be sure to consult your healthcare provider if you’re struggling with pain management or unusual symptoms during your recovery.
A lymphadenectomy can:
Risks of lymph node surgery include:
Side effects of having your lymph nodes removed can include:
The results of your lymphadenectomy will tell you and your healthcare provider more about your cancer stage and prognosis. This will involve the stage and type of cancer being treated. If you did have cancer in your lymph nodes, you’re statistically more at risk of cancer recurring (returning) after treatment. However, removing the affected lymph nodes is the surest way of removing all the cancer cells.
Call your healthcare provider if you experience:
A note from Cleveland Clinic
Lymphadenectomy, or lymph node dissection, is an important step in staging and treating cancer. It gives your healthcare team crucial information about your condition and may stop cancer from spreading in the process. Like all surgeries, it can involve certain risks and complications, which may be short-term or long-term. Side effects may diminish your quality of life, but overall, lymphadenectomy may save it.
Last reviewed by a Cleveland Clinic medical professional on 08/15/2022.
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