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Introduction
Lymph node removal is a surgical procedure to take out one or more of your lymph nodes.
Your doctor may recommend you have this procedure if you’ve been diagnosed with cancer.
It can help to check whether cancer has spread, or reduce the chance of it coming back.
Your lymph nodes help to fight infection and filter lymph fluid. They trap any bacteria and
waste products in lymph and destroy old or abnormal cells, such as cancer cells.
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One or more lymph nodes may be removed to check whether your cancer has spread.
Knowing this helps your doctor plan the best treatment for you.
If tests have shown that the cancer has reached your lymph nodes, you may have them
taken out to remove the cancer. This helps to reduce the chance of your cancer coming
back.
Lymph nodes can often become swollen due to infection, as well as autoimmune diseases,
and more rarely, cancer. Having swollen lymph nodes doesn’t mean that you’ll necessarily
need your lymph nodes removed. Swollen lymph nodes often get better on their own. But if
they don’t after a few weeks, contact your GP.
Surgery to remove lymph nodes may be done at the same time as your main surgery for
cancer. Or, it may be done as a separate procedure.
Lymph node biopsy – just one or two nodes are removed to check for cancer cells.
Sentinel lymph node – this is the first lymph node your cancer is likely to spread to.
Sentinel lymph node biopsy – removal of the sentinel lymph node. It’s usually done if
you have breast cancer or melanoma (skin cancer).
Lymph node dissection (or clearance) – this is when all the lymph nodes in a particular
area are removed. An example is axillary lymph node dissection for breast cancer. In
this procedure, your surgeon removes a number of lymph nodes from your armpit
(axilla).
You’ll probably be invited to a pre-admission assessment clinic at the hospital a week or two
before your operation. Here, a nurse will do some general checks and tests to make sure
you’re well enough for surgery.
Although some lymph node surgeries can be done as a day-case, you will often need to stay
in hospital for one or more nights. Your healthcare team should let you know what to expect.
If you need to, make arrangements for a stay in hospital and for help at home afterwards.
At the hospital
On the day of your procedure, your surgeon or nurse will check you’re feeling well and happy
to go ahead. The staff at the hospital will do any final checks and get you ready for surgery.
They may ask you to wear compression stockings, or have an injection of an anticlotting
medicines, to help prevent deep vein thrombosis (DVT).
If you’re having a sentinel lymph node biopsy, you may need to have a scan before your
operation, to help find the sentinel node. This involves having an injection of a tracer (a
radioactive liquid) that can show up on a scan. The radiographer who performs the scan will
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be able to identify the sentinel node as the first lymph node that the radioactive liquid goes
into. They may mark its position on your skin for your surgeon to see.
Lymph node removal can be carried out via open or keyhole surgery. Which you have will
depend on the area of the body being operated on.
In open surgery, your surgeon will make a cut in the affected area and identify the lymph
nodes they’re going to remove. They’ll then carefully remove them and possibly some other
tissue nearby that may have cancer cells. Your surgeon may put a fine tube (called a drain) in
place, to drain fluid from your wound. This will be taken out after a few days. At the end of the
operation, your surgeon will close the cut with dissolvable stitches, non-dissolvable stitches,
staples or skin glue.
In keyhole surgery, your surgeon will make a small cut (or cuts) in the affected area. They’ll
use surgical instruments (including a camera) passed through the cuts to view your lymph
nodes and remove them.
If you’ve had a general anaesthetic, you’ll need to rest until the effects wear off. You might
have some discomfort as the anaesthetic wears off, but you’ll be offered pain relief if you
need it. .
You might find that you’re not so co-ordinated or that it’s difficult to think clearly after a
general anaesthetic. This should pass within 24 hours. In the meantime, don’t drive, drink
alcohol, operate machinery or sign anything important. If you’re going home the same day as
your general anaesthetic, you’ll need to arrange for someone to drive you. This is a good idea
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even if you had a local anaesthetic. You should also have an adult stay with you for the first 24
hours.
If your surgeon used dissolvable stitches to close your cut, these won’t need to be removed.
They’ll usually dissolve completely within a few weeks, depending on which type your
surgeon used. If you had non-dissolvable stitches or staples, you’ll need to have these
removed after a week or so. If you have skin glue, this should flake off on its own over two to
three weeks.
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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.
Any other effects that you may have after your operation will depend on where your lymph
nodes were removed from. For instance, side-effects of lymph node removal in your armpit
may include stiffness in your shoulder. You can do exercises to help with this. After lymph
node removal from your neck, you may have some weakness on one side of your mouth. This
usually returns to normal in a few months.
How long it takes to recover after lymph node removal surgery will depend on your
circumstances and type of surgery you’ve had. It might just take a couple of weeks after
lymph node surgery for melanoma, for example. But it may be several months for more major
surgery, like lymph node removal for testicular or breast cancer. Ask your surgeon when
you’re likely to be able to get back to your usual activities, including returning to work. Check
if there are any restrictions on what you can do while you’re recovering like strenuous exercise
or heavy lifting.
You’re more likely to develop lymphoedema if you have several lymph nodes removed and if
you have radiotherapy. You’ll continue to be at risk of developing lymphoedema for the rest
of your life after having lymph nodes removed. But there are many things you can do to keep
this risk as low as possible. These include keeping to a healthy weight and being active.
Sepsis (adults)
Sepsis is a life-threatening complication that can develop if you get an infection. Sepsis is a
medical emergency. Call 999 or go to A&E immediately if you have any of the following
symptoms.
Our information has been awarded the PIF TICK for trustworthy health information. It also
follows the principles of the The Information Standard.
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Related information
Cancer - an overview
What causes cancer? What are the different types? And how is it treated? The answers to
these questions and more in our overview of cancer.
Read more
Lymphoedema
Lymphoedema is the build-up of a fluid called lymph, which causes a body part to swell up.
Read more
Breast cancer
Breast cancer is the most common cancer in the UK, with around 150 women diagnosed
every day.
Read more
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