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Neck lymph node dissection

This page gives you some information about this operation, as well as what to expect while you are in hospital and afterwards. It also includes some complications that can occur, but is not an exhaustive list. If you have any questions – please ask.

What does this operation involve?

A neck dissection operation involves removing the lymph nodes from one side of your neck, along with some surrounding connective and fatty tissue.

Lymph is a colourless fluid that surrounds all body tissues. It drains from the tissues into small lymph vessels which lie between cells. The small lymph vessels join together to form larger lymph vessels which then pass through a number of lymph nodes.

The lymph nodes act as filters where bacteria and harmful substances are broken down. The lymph fluid then flows through larger lymph ducts and drains into the bloodstream. A tumour can spread from its original site through lymphatic vessels to regional lymph nodes. The aim of the neck dissection is to remove the regional lymph nodes together with any tumour that has developed in them.

You will have a general anaesthetic for this operation. Before your operation you will see an anaesthetist and can ask them any questions you may have about your anaesthetic. There are always risks associated with having surgery. If you have any medical conditions, you must tell your surgeons and your anaesthetist.

What complications can happen?

There are some possible complications associated with a neck dissection operation. These include bleeding, wound breakdown, infection, fluid collection and lymphoedema.

Bleeding after your operation can cause a collection of blood called a haematoma. Haematomas are usually removed in another operation.

Simple infections are treated with antibiotics. You may need to have antibiotics in theatre.

It is possible, but not inevitable that you may have some swelling in your neck, shoulder or arm after a neck dissection operation. This is called a lymphoedema. It happens because the flow of lymph fluid through the lymphatic vessels in your neck, shoulder and arm is disrupted after the surgery.

If this does happen, your surgeon and specialist nurses will be able to tell you how to manage the lymphoedema and refer you to specialist therapists if necessary.

Important!

If you notice increasing redness, swelling or pain from your wound, tell your surgeon or the staff looking after you as soon as possible. It is much easier to treat infections that are caught early.

What to expect when you come into hospital

You will usually go to hospital the day before your operation. A nurse will settle you into the ward. You will see a member of your surgical team, who will explain your operation, answer any questions or concerns you may have and gain your consent for the surgery.

You will need to have some routine investigations carried out before your operation such as blood tests, X-rays and heart tracings known as ECGs. You may have already had these investigations at a pre-assessment appointment. You can read more about Having an anaesthetic.

What to expect when you come back from theatre

You will have a scar running down one side of your neck and perhaps extending a short way across the front of your shoulder. You will have stitches along the scar and dressings in place to cover it. The type of stitch used depends on the surgeon's choice. If they are not dissolving stitches, they will need to be taken out after 12 to 14 days after your operation.

When you return to the ward, the nurses will check your wound, your pulse and your blood pressure regularly. You will also have a drip in place. This will be giving you fluids through a vein and will stay in until you are eating and drinking. It is usual for you to be up and about the day after your operation. Nurses will give you guidance and help.

You will also have a wound drain to drain any fluid and bleeding away from the wound, through a tube and into a bag. This usually stays in for three to four days but it may be longer. You will probably go home once your wound drain comes out.

What to expect when you go home

When you leave hospital, you may be given an appointment to attend the Dressing Clinic, where a nurse will have a look at your wound. If you have a collection of fluid (called a seroma), you may need several appointments to drain this. If your wound needs regular dressing changes after you leave hospital, the ward staff will help you organise your local practice or district nurses to do these for you. You may also have an appointment for the Dressing Clinic so a member of the Plastic Surgery Department can monitor your wound as well.

You will also get an appointment to see your plastic surgeon in the Outpatient Clinic. It will usually be for between two and six weeks after your surgery, but the timing may vary. If you can't attend your appointment, please contact the clinic and arrange another appointment. It is important that the surgeons continue to see you after you have left hospital.

You will feel tired after your surgery and should take things very easy for the first week or so after you leave hospital. As you feel able, build up your normal activities.

Depending on your job and the extent of your surgery, you may be able to go back to work after three to four weeks. If your job involves lifting or heavy work, you may need more time away from work. Check with your surgeon or your GP before returning to work. Your GP will be able to organise a sick certificate to cover you for your time away from work.

You will usually be able to return to driving after four to six weeks but check with your insurance company first. Your surgeon, specialist nurses or GP can advise you regarding this. You must not drive if you are still feeling unwell.

If, having read this page, you have any questions about this operation or the risks involved, please contact the Plastic Surgery Department or raise these queries when you come for surgery, when the surgeons will answer your questions.

Written by plastic surgeon, Jeremy Simcock. Adapted by HealthInfo clinical advisers. Updated September 2016.

See also:

Having an anaesthetic

Neck lumps

Image courtesy of graur codrin at FreeDigitalPhotos.net

Page reference: 87548

Review key: HIMEL-15455