While the health information and fact sheets on this website relate to world-wide situations, the drug names will vary between countries – therefore the advice of your local GP should be sought.
|The health information and factsheets on this website are produced by Bupa's health information team. The information is reviewed and approved by relevant healthcare professionals, including doctors, dentists, nurses, physiotherapists and dietitians.||
|Browse the a-z list of factsheets:||
Lymph node removal (lymphadenectomy)
Published by Bupa's health information team, November 2008.
This factsheet is for people who are planning to have lymph nodes removed (lymphadenectomy), or who would like information about it.
Lymph nodes are small kidney bean-shaped organs located throughout the body particularly in the armpits, neck and groin. They filter fluid that travels through them, removing any dying cells and bacteria. If you have cancer, the lymph nodes closest to the cancer may be affected and will need to be removed in some circumstances.
Your care will be adapted to meet your individual needs and may differ from what is described here. So it's important that you follow your surgeon's advice.
About lymph nodes
Lymph nodes (or glands) are part of the body's natural defence system called the lymphatic system. Their main function is to fight infection and filter lymphatic fluid. If you have cancer, your surgeon may recommend removing the lymph nodes closest to the tumour to help find out if the cancer has spread (called cancer staging), plan appropriate treatment and/or remove cancer that's already in the lymph nodes.
Depending on the size and location of your cancer, your surgeon may remove all or some of the lymph nodes closest to the cancer whilst removing the primary tumour (for example, in some types of breast cancer the surgeon removes the lymph nodes in the armpit at the same time as the breast tumour).
The lymphatic system
What are the alternatives to lymphadenectomy?
Your surgeon may suggest having a sentinel lymph node biopsy (SLNB) to help identify the first lymph node that tumour cells drain into. The sentinel lymph node is removed and tested for cancer. If the results come back negative, it means the cancer hasn't spread to the lymph nodes and they don't need to be removed. For more information about sentinel lymph node biopsy see the related Bupa factsheet.
Preparing for your operation
Your surgeon will explain how to prepare for your operation. For example, if you smoke, you will be asked to stop as smoking increases your risk of getting a chest and wound infection, which can slow your recovery.
Depending on the surgical technique used, and the extent of your surgery, you may need to stay in hospital for up to three days.
Lymph nodes are usually removed under general anaesthesia. This means you will be asleep during the procedure.
You will be asked to follow fasting instructions. Typically, you must not eat or drink for about six hours before a general anaesthetic. However some anaesthetists allow occasional sips of water until two hours beforehand.
At the hospital your nurse may check your heart rate and blood pressure, and test your urine.
Your surgeon will explain the procedure and ask you to sign a consent form. This confirms that you understand the risks, benefits and possible alternatives to the procedure and have given your permission for it to go ahead.
Your nurse will prepare you for theatre. You may be asked to wear compression stockings to help prevent blood clots forming in the veins in your legs.
About the operation
The operation usually takes 45 minutes. A small cut is made over the lymph node area. The lymph nodes are removed and sent to a laboratory for testing. The cut is closed with dissolvable stitches.
What to expect afterwards
You will need to rest until the effects of the anaesthetic have passed. You may need pain relief to help with any discomfort as the anaesthetic wears off.
Fine plastic tubes may be left in your wound for up to 48 hours afterwards. These allow blood and fluids to drain into a bag. You may be given the option to go home with the drainage tube still in place. In this case, a nurse will remove the drain at your follow-up appointment.
You will have a dressing covering your wound. This is usually removed on the second day. You will then be able to take a shower or bath. Dissolvable stitches will disappear on their own in seven to 10 days.
If you have lymph nodes removed from under your armpit or groin area, a physiotherapist (a specialist in movement and mobility) will teach you exercises designed to help your recovery.
You will need to arrange for someone to drive you home. You should try to have a friend or relative stay with you for the first 24 hours.
Your nurse will give you some advice about caring for your healing wounds before you go home. You will be given a date for a follow-up appointment.
Your results will be ready several days later and will usually be sent in a report to the doctor who requested your procedure. Your doctor will review the results and discuss them with you at your follow-up appointment.
Recovering from lymphadenectomy?
If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice.
General anaesthesia temporarily affects your coordination and reasoning skills, so you must not drink alcohol, operate machinery or sign legal documents for 48 hours afterwards.
You shouldn't drive until you are confident that you could perform an emergency stop without discomfort. If you are in any doubt about driving, please contact your motor insurer so that you are aware of their recommendations, and always follow your surgeon's advice.
Take it easy and don't do any strenuous exercise or heavy lifting for several weeks.
If you had lymph nodes removed from your armpit or groin, keep the arm or leg on the side of the operation mobile so that it doesn't get stiff. Don't remove any hair from the area until the cut is fully healed. Don't use a deodorant or talc in the area as these can irritate the healing wound.
Contact your GP if you have any of the following symptoms, as you may have developed an infection:
severe pain or pain that lasts for more than 48 hours
a high temperature
discharge from the wound
What are the risks?
Lymph node removal is commonly performed and generally safe. However, in order to make an informed decision and give your consent, you need to be aware of the possible side-effects and the risk of complications of this procedure.
These are the unwanted but mostly temporary effects of a successful operation, for example feeling sick as a result of the general anaesthetic.
Common side-effects of lymph node removal include:
pain, swelling and bruising - this usually improves as the wound heals
stiffness - gentle exercises can help reduce any stiffness in the affected arm or leg
numbness - this can happen if nerves are damaged during surgery but it's usually temporary
This is when problems occur during or after the operation. Most people are not affected. The possible complications of any operation include an unexpected reaction to the anaesthetic, infection, excessive bleeding or developing a blood clot, usually in a vein in the leg (deep vein thrombosis, DVT).
Specific complications of lymph node removal are uncommon but can include:
infection - you may need antibiotics
build up of fluid in the lymph node area (seroma) or affected arm or leg (lymphoedema) - you may need to have the fluid drained
The exact risks are specific to you and differ for every person, so we have not included statistics here. Ask your surgeon to explain how these risks apply to you.
Lymph node removal (lymphadenectomy) Q&As
See our answers to common questions about lymphadenectomy, including:
- The lymphatic system. Cancerbackup. www.cancerbacup.org.uk, accessed 22 July 2008
- Sato K, Tamaki K, Takeuchi H, et al. Management of the axilla in breast cancer: a comparative study between sentinel node biopsy and four-node sampling procedure. Jpn J Clin Oncol 2001; 31(7):318-321
- Warmuth MA, Bowen G, Prosnitz LR, et al. Complications of axillary lymph node dissection for carcinoma of the breast: a report based on a patient survey. Cancer 1998; 83(7):1362-1368
This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.
Publication date: November 2008