What is neck lymph node dissection?

A neck lymph node dissection is surgery to remove all or some of the lymph nodes and surrounding tissue from the neck. Lymph nodes are small, round or bean-shaped glands. They remove germs from your body, help fight infection, and trap cancer cells. This surgery is most often done to treat cancer of the head and neck.

You and your doctor will plan your treatment based on your wishes and the reason for your surgery. Every person's treatment is different. Sometimes surgery to remove a tumor is done at the same time. In this case, your doctor may give you other information to help you prepare for both surgeries.

You will be asleep during the surgery. Your doctor may make cuts under your chin and toward your ear, at the bottom of your neck, or in the middle of your neck. This depends on which lymph nodes must be removed. The cuts are called incisions. They are closed with stitches, staples, or skin clips. They will leave scars that fade with time.

Most people stay in the hospital for several days or longer after surgery. How long you stay depends on why you need surgery and how much tissue was taken out.

You may be able to go back to work or your normal routine a few weeks after the surgery. This depends on your job and the extent of your surgery.

Activity

• Rest when you feel tired. Getting enough sleep will help you recover. When you lie down, put 2 or 3 pillows under your upper back and shoulders so that your neck and head are supported.
• Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
• Avoid strenuous physical activity, lifting heavy objects, and airplane travel for 3 weeks after surgery or until your doctor says it is okay.
• Ask your doctor when you can drive again.
• You may be able to take showers (unless you have a drain near your incision). If you do have a drain near your incision, follow your doctor's instructions to empty and care for it.

Diet

• If it is painful to swallow, start out with cold drinks, flavored ice pops, and ice cream. Next, try soft foods like pudding, yogurt, canned or cooked fruit, scrambled eggs, and mashed potatoes. Avoid eating hard or scratchy foods like chips or raw vegetables. Avoid orange or tomato juice and other acidic foods that can sting the throat.
• If you cough right after drinking, try drinking thicker liquids, such as "smoothies."
• You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. You may want to take a fiber supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.

Medicines

• Your doctor will tell you if and when you can restart your medicines. You will also get instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• Take pain medicines exactly as directed.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
• If you think your pain medicine is making you sick to your stomach:
  • Take your medicine after meals (unless your doctor has told you not to).
  • Ask your doctor for a different pain medicine.
• Your doctor may have prescribed antibiotics. Take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

Incision care

• If your doctor told you how to care for your incision, follow your doctor's instructions. If you did not get instructions, follow this general advice:
  • After the first 24 to 48 hours, wash around the incision with clean water 2 times a day. Don't use hydrogen peroxide or alcohol, which can slow healing.
• You may have a drain near your incision. Your doctor will tell you how to take care of it.

Exercise

• If you have trouble with shoulder and arm strength and movement, you may need physical therapy. Your doctor or physical therapist will help you with this.

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

A neck dissection is surgery to remove all or some of the lymph nodes and surrounding tissue from the neck. Lymph nodes are small, round or bean-shaped glands that act like filters. They remove germs from your body, help fight infection, and trap cancer cells. This surgery is most often done to treat cancer of the head and neck.

You may leave the hospital with stitches in your cut (incision). Your doctor will tell you if you need to return to have these removed. You may still have a tube called a drain in your neck. Your doctor will probably take this out a few days after your surgery.

The area may also be swollen, and you may have a stiff neck. For most people, the swelling starts to go away 4 to 5 days after surgery. You may have numbness in your neck and ear. Your lower lip or shoulder may feel weak. For most people, these problems go away in 6 to 12 months. But sometimes these problems can be permanent. You may always feel a little numb, stiff, or weak in some areas.

If a neck muscle was removed, your neck may look flatter or thinner.

If you have cancer, you may still need other treatment after surgery, such as radiation or chemotherapy.

• Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
• Follow your doctor's instructions about when to bathe or shower before your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
• Do not shave the surgical site yourself.
• Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

• Bring a picture ID.
• The area for surgery is often marked to make sure there are no errors.
• You will be kept comfortable and safe by your anesthesia provider. You will be asleep during the surgery.
• The surgery will take about 2 to 4 hours.