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Lymph node dissection

A lymph node dissection operation involves removing some of your lymph nodes. Some surrounding connective and fatty tissue are also removed at the same time.

• An armpit (axillary) dissection removes the lymph nodes under your armpit.
• A groin dissection removes the lymph nodes in your groin.
• A neck dissection removes the lymph nodes from one side of your neck.

Lymph is a colourless fluid that surrounds all body tissues. It drains from the tissues into small lymph vessels that lie between cells.

The small lymph vessels join together to form larger lymph vessels that then pass through several 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 your bloodstream.

A tumour can spread from its original site through lymphatic vessels to regional lymph nodes. The aim of a lymph node dissection operation is to remove the regional lymph nodes, along with any tumour that has developed in them.

You will have a general anaesthetic for this operation (you will be asleep). 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. Tell your surgeons and your anaesthetist if you have any medical conditions.

Possible complications of a lymph node dissection operation

There are some possible complications of a lymph node 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 the operating theatre.

There is a chance that your arm may swell after having a lymph node dissection. This is called lymphoedema. It happens because the flow of lymph fluid through your lymphatic vessels 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. They will refer you to specialist therapists if necessary.

What to expect when you go 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. They will answer any questions or concerns you may have and gain your consent for the surgery.

You will need to have some routine investigations 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 the operating theatre

You will have scar where the lymph nodes were removed and stitches along the scar. There will also be a dressing over the scar. The type of stitch used depends on the surgeon's choice. If they are not dissolving stitches, you will need to have them taken out 12 to 14 days after your operation.

When you return to the ward, the nurses will check your wound, our pulse and blood pressure regularly. You will 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 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 3 to 4 days, but it may need to be in 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 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 general practice team or district nurses to do these. You may also have an appointment for the Dressing Clinic so a member of the Plastic Surgery Department can monitor your wound.

You will also get an appointment to see your plastic surgeon in the Outpatient Clinic. It will usually be between 2 and 6 weeks after your surgery, but the timing may vary. If you cannot 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 3 to 4 weeks. If your job involves lifting or heavy work, you may need more time away from work. Check with your surgeon or general practice team before returning to work. Your general practice team can organise a medical certificate to cover you for your time away from work.

You will usually be able to drive again after 3 to 4 weeks but check with your insurance company first. Your surgeon, specialist nurses or general practice team will be able to advise you about this. Do not drive if you are still feeling unwell.

If you have questions about the operation or the risks involved, please contact the Plastic Surgery Outpatients Department. Or the surgeons will answer your questions when you come in for the surgery.

Written by plastic surgeon, Te Whatu Ora Waitaha. Adapted by HealthInfo clinical advisers. Last reviewed September 2024.

Sources

Page reference: 874176

Review key: HILYM-874168