Lymph node removal

Lymph nodes are part of the immune system and therefore play an important role in the prevention of viruses and bacteria. They filter the lymph fluid and are thus often the first place where metastases from tumour cells spread.

Lymph nodes are therefore removed for diagnostic and therapeutic purposes. Diagnostic lymph node removal is used to determine the cause of unclear lymph node swellings. If a patient is diagnosed with cancer, the lymph nodes which are closest to the tumour (sentinel lymph nodes) are checked for cancer metastases. Therapeutic lymph node removal is used when the lymph nodes already contain metastases or to prevent the metastisation in the lymph nodes.

Typical places where lymph nodes are removed are: the armpits in the case of breast cancer, the groin area in the case of cancers of the pelvic organs, the neck in the case of tumours in the head, neck area.

What preparations are carried out before the procedure?

Different clarifications are undertaken before the lymph nodes are removed. Blood tests provide evidence of an infection or possible cancer.  Suspicious lymph nodes are precisely localised with an ultrasound or with other examinations. Sometimes the lymph nodes are initially punctured before the removal.

How is the operation carried out?

The operation is usually performed on an outpatient basis. Surface lymph nodes in the neck, in the armpits or in the groin area can usually be removed under local anaesthesia. Deep-rooted lymph nodes are often removed during the actual tumour surgery under general anaesthetic. Surface lymph nodes are removed via a small incision; the procedure takes approximately thirty minutes. The removed lymph nodes are thoroughly examined. Different methods can be used to search for cancer cells or pathogens.

What is the success rate of this procedure?

If the lymph nodes are removed for diagnostic purposes, the correct diagnosis can usually be made with the help of the following examination. The success of the therapeutic removal of the cancers depends, among other things, on the type of cancer as well as the spread and the aggression of the tumour. In general, the risk of the cancer spreading can be reduced by removing the lymph nodes.

What are the possible complications and risks of this procedure?

The removal of surface lymph nodes is a low-risk procedure. As with all surgery, the operation may occasionally lead to nerve, blood vessel damage, infections or wound healing disorders. Removal of a large number of lymph nodes can affect the flow of the lymph fluid and cause lymph oedemas to form.

What happens after the operation?

Sometimes, a drainage tube is inserted; it can be removed in one to three days. If there is diagnostic clarification, the next steps will be decided based on the findings from the examined lymph nodes. After therapeutic removal of lymph nodes, the treatment of the underlying cancer is continued.