Lymphadenectomy: Surgical Lymph Node Removal—Indications and Types

Definition

Lymphadenectomy (lymph node dissection) is the surgical removal of one or more lymph nodes.

Indications

• Diagnostic: Biopsy for staging (e.g., sentinel lymph node biopsy in melanoma, breast cancer).
• Therapeutic: Removal of metastatic nodes (e.g., neck dissection for head/neck cancer, axillary dissection for breast cancer).
• Prophylactic: Elective removal in high-risk fields.

Common Types

• Sentinel lymph node biopsy (SLNB): Removal of the first draining node(s).
• Regional lymphadenectomy: En bloc removal of a nodal basin (axillary, inguinal, cervical, pelvic, retroperitoneal).
• Radical vs. Modified: Extent of non-lymphatic tissue removal.

Risks

Lymphedema, nerve injury, seroma, infection, vascular injury. Sentinel node biopsy minimizes morbidity.