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A lymphadenectomy, also known as lymph node dissection, is a surgical procedure to remove one or more lymph nodes or groups of lymph nodes, which are then evaluated for the presence of cancer.
Why It's Done
Patients being evaluated for advanced melanoma will first undergo a sentinel lymph node biopsy (SLNB) near the site of the tumor. The sentinel node is the first lymph node that cancer cells encounter as they travel along the lymphatic vessels.
The draining sentinel node is identified by the surgeon through a procedure known as "sentinel lymph node mapping". The node is then excised (removed) and evaluated by a pathologist for the presence of cancer. If the sentinel node is free of cancer, this is highly predictive of freedom from metastasis in the nearby regional lymph nodes.
Conversely, patients with a positive or "involved" sentinel lymph node are likely have cancer in other lymph nodes indicating the need for more aggressive treatment such as a selective or complete lymphadenectomy. In this procedure, also known as a "formal lymph node dissection", some or all of the regional lymph nodes are removed and evaluated for cancer, the intent being to prevent further metastasis of the melanoma, regionally or to distant organs.
A lymphadenectomy is usually performed under general anesthesia . An incision is made in the skin above the area of the affected lymph nodes. The lymph nodes, nearby lymphatic tissue and some underlying soft tissue are then removed and evaluated (dissected).
Risks
Risks of lymphadenectomy include:
- Buildup of fluid at the site of surgery (seroma)
- Infection
- Lymphedema, swelling of a limb affected by removal of lymph nodes
- Numbness, tingling, or pain in area of surgery
- Sloughing (breakdown) of skin in the area of surgery
