{"id":30,"date":"2018-01-30T21:03:42","date_gmt":"2018-01-31T02:03:42","guid":{"rendered":"https:\/\/www.saintjohnscancer.org\/melanoma\/treatment\/completion-node-dissection\/"},"modified":"2025-04-21T17:52:18","modified_gmt":"2025-04-21T21:52:18","slug":"completion-node-dissection","status":"publish","type":"page","link":"https:\/\/www.saintjohnscancer.org\/melanoma\/treatment\/completion-node-dissection\/","title":{"rendered":"Completion Node Dissection"},"content":{"rendered":"","protected":false},"excerpt":{"rendered":null,"protected":false},"author":2,"featured_media":0,"parent":22,"menu_order":3,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"class_list":["post-30","page","type-page","status-publish","hentry"],"acf":{"layers":[{"acf_fc_layout":"layer_content_sidebar","layer_label":"","layer_headline":"","layer_intro":"","layer_content":"

Complete Lymph Node Dissection (LND) involves removing all the lymph nodes in the affected region where the cancer can drain. This procedure is performed in the operating room and typically requires an overnight stay at our health center. At Saint John\u2019s Health Center in Santa Monica, CA, we adopt a multidisciplinary approach to care, involving specialists across various disciplines. These experts participate in cancer tumor boards, where they evaluate and discuss each case in detail.\u00a0<\/p>\n

Lymph Node Dissection Procedure<\/h2>\n

If lymph nodes appear abnormally hard or enlarged during clinical exams or radiologic exams, a fine-needle aspiration (FNA) biopsy or excisional biopsy may be performed. If melanoma is detected in a node or nodes, a lymph node dissection is usually recommended. Previously, most doctors advised removing the lymph node if a sentinel lymph node was found to be positive. However, a recent multi-center international clinical trial, MSLT-II, conducted by the Saint John\u2019s Cancer Institute, showed no difference in survival between patients who underwent a complete node dissection and those who were frequently observed with clinical exams and ultrasounds of the lymph node basin. <\/p>\n

What to Expect with Lymph Node Dissection<\/h2>\n

A completion node dissection is performed after a positive sentinel lymph node is found or when a palpable lymph node or nodes are present. This surgery is typically longer and may require an overnight hospital stay. Drains are placed during the operation to help remove fluid that may accumulate at the surgical site. The risk of lymphedema is higher than with a sentinel lymph node procedure, so it is essential to monitor the limb for any swelling. Prompt referrals to physical therapy can help prevent further swelling.<\/p>\n

\n

Recovery and Side Effects<\/h3>\n

One potential complication after a complete lymph node dissection is lymphedema. Lymph nodes under the arm or in the groin help drain fluid, and their removal can lead to fluid accumulation, known as lymphedema. This can cause swelling, which may or may not resolve over time. Elastic stockings, compression sleeves, and physical therapy can help manage this condition.<\/p>\n

\"Lymph
Patients may experience side effects of LND such as pain or sensitivity around the site.<\/figcaption><\/figure>Since this surgery is more extensive than a sentinel lymph node biopsy, narcotic pain medications may be necessary. You will learn how to care for your JP drain and receive instructions on when it can be safely removed. Generally, you will be able to move around the day after surgery, although there may be some limitations on physical activities. You will receive detailed postoperative instructions.<\/p>\n

Possible Side Effects\u00a0<\/strong><\/p>\n