Lymphadenectomy, or lymph node dissection, is the surgical removal of one or more groups of

lymph node A lymph node, or lymph gland, is a kidney-shaped organ of the lymphatic system and the adaptive immune system. A large number of lymph nodes are linked throughout the body by the lymphatic vessels. They are major sites of lymphocytes that includ ...

s. It is almost always performed as part of the surgical management of cancer. In a regional lymph node dissection, some of the lymph nodes in the

tumor A neoplasm () is a type of abnormal and excessive growth of tissue. The process that occurs to form or produce a neoplasm is called neoplasia. The growth of a neoplasm is uncoordinated with that of the normal surrounding tissue, and persists ...

area are removed; in a radical lymph node dissection, most or all of the lymph nodes in the tumor area are removed.

Indications

Lymphadenectomies are usually done because many types of

cancer Cancer is a group of diseases involving Cell growth#Disorders, abnormal cell growth with the potential to Invasion (cancer), invade or Metastasis, spread to other parts of the body. These contrast with benign tumors, which do not spread. Po ...

have a marked tendency to produce lymph node

metastasis Metastasis is a pathogenic agent's spreading from an initial or primary site to a different or secondary site within the host's body; the term is typically used when referring to metastasis by a cancerous tumor. The newly pathological sites, ...

early in their natural histories. This is particularly true of

melanoma Melanoma is the most dangerous type of skin cancer; it develops from the melanin-producing cells known as melanocytes. It typically occurs in the skin, but may rarely occur in the mouth, intestines, or eye (uveal melanoma). In very rare case ...

head and neck cancer Head and neck cancer is a general term encompassing multiple cancers that can develop in the head and neck region. These include cancers of the mouth, tongue, gums and lips (oral cancer), voice box ( laryngeal), throat ( nasopharyngeal, orophary ...

, differentiated

thyroid cancer Thyroid cancer is cancer that develops from the tissues of the thyroid gland. It is a disease in which cells grow abnormally and have the potential to spread to other parts of the body. Symptoms can include swelling or a lump in the neck, ...

breast cancer Breast cancer is a cancer that develops from breast tissue. Signs of breast cancer may include a Breast lump, lump in the breast, a change in breast shape, dimpling of the skin, Milk-rejection sign, milk rejection, fluid coming from the nipp ...

lung cancer Lung cancer, also known as lung carcinoma, is a malignant tumor that begins in the lung. Lung cancer is caused by genetic damage to the DNA of cells in the airways, often caused by cigarette smoking or inhaling damaging chemicals. Damaged ...

gastric cancer Stomach cancer, also known as gastric cancer, is a malignant tumor of the stomach. It is a cancer that develops in the lining of the stomach. Most cases of stomach cancers are gastric carcinomas, which can be divided into a number of subtypes ...

, and

colorectal cancer Colorectal cancer (CRC), also known as bowel cancer, colon cancer, or rectal cancer, is the development of cancer from the Colon (anatomy), colon or rectum (parts of the large intestine). Signs and symptoms may include Lower gastrointestinal ...

. Famed British surgeon Berkeley Moynihan once remarked that "the surgery of cancer is not the surgery of organs; it is the surgery of the lymphatic system." The better-known examples of lymphadenectomy are '' axillary lymph node dissection'' for breast cancer; ''radical neck dissection'' for head and neck cancer and thyroid cancer; ''D2 lymphadenectomy'' for gastric cancer; and '' total mesorectal excision'' for rectal cancer.

With sentinel node biopsy

For clinical stages I and II breast cancer, axillary lymph node dissection should only be performed after first attempting a sentinel node biopsy., which cites various primary research studies. A sentinel node biopsy can establish cancer staging of the

axilla The axilla (: axillae or axillas; also known as the armpit, underarm or oxter) is the area on the human body directly under the shoulder joint. It includes the axillary space, an anatomical space within the shoulder girdle between the arm a ...

if there are positive lymph nodes present. It is also less risky than performing a lymphadenectomy, having fewer side effects and a much lower chance of causing

lymphedema Lymphedema, also known as lymphoedema and lymphatic edema, is a condition of localized edema, swelling caused by a compromised lymphatic system. The lymphatic system functions as a critical portion of the body's immune system and returns inters ...

. If cancer is not present in the sentinel lymph nodes, then the axillary lymph node dissection should not be performed. If one or two sentinel nodes have cancer that is not extensive, then no axillary dissection should be performed, but the person with cancer should have breast-conserving surgery and

chemotherapy Chemotherapy (often abbreviated chemo, sometimes CTX and CTx) is the type of cancer treatment that uses one or more anti-cancer drugs (list of chemotherapeutic agents, chemotherapeutic agents or alkylating agents) in a standard chemotherapy re ...

appropriate for their stage of cancer.

Complications

Lymphedema Lymphedema, also known as lymphoedema and lymphatic edema, is a condition of localized edema, swelling caused by a compromised lymphatic system. The lymphatic system functions as a critical portion of the body's immune system and returns inters ...

may result from lymphadenectomy. Extensive resection of lymphatic tissue can lead to the formation of a lymphocele. It is uncertain whether inserting wound drainage after groin lymph nodes dissection can reduce complications such as seroma, haematoma, wound dehiscence, and wound infection.

References

External links

Axillary Lymph Node Dissection - online learning resource
{{Authority control Surgical oncology Lymphatic organ surgery

Indications

With sentinel node biopsy

Complications

See also

References

External links