38720 Cervical lymphadenectomy (complete)

Name of the Procedure:

Cervical Lymphadenectomy (Complete)

Summary

A cervical lymphadenectomy, also known as a complete neck dissection, is a surgical procedure to remove lymph nodes from the neck region. This is typically performed to treat or prevent the spread of cancer.

Purpose

This procedure addresses cancers that have spread to the lymph nodes in the neck, such as head and neck cancers, thyroid cancer, and metastatic melanoma. The main goal is to remove cancerous lymph nodes and reduce the risk of cancer spreading to other parts of the body.

Indications

• Presence of cancerous tumors in the head, neck, or throat.
• Evidence of metastasis to cervical lymph nodes.
• Enlarged or suspicious lymph nodes detected through imaging or physical exams.

Preparation

• Patients may need to fast for several hours before the surgery.
• Medication adjustments may be necessary, particularly for blood thinners.
• Preoperative imaging studies such as CT scans or MRIs.
• Blood tests and possibly a biopsy of the lymph nodes.

Procedure Description

1. The patient is given general anesthesia.
2. An incision is made in the neck to expose the lymph nodes.
3. The surgeon carefully removes the lymph nodes along with any surrounding tissue that may be involved.
4. The area is examined for any remaining cancerous tissue.
5. The incision is closed with sutures or staples and a drainage tube may be placed to prevent fluid buildup.

6. The patient is taken to recovery for monitoring.

   Tools used may include scalpels, forceps, electrocautery devices, and surgical staplers.

Duration

The procedure typically takes 2 to 4 hours, depending on the extent of lymph node involvement and complexity.

Setting

The procedure is generally performed in a hospital or a specialized surgical center.

Personnel

• Surgeon specialized in head and neck cancers.
• Surgical nurses.
• Anesthesiologist.
• Operating room technician.

Risks and Complications

• Common: Infection, bleeding, swelling, pain, and scar formation.
• Rare: Nerve damage leading to muscle weakness or numbness, injury to blood vessels, recurrent laryngeal nerve injury affecting voice, and potential lymphedema.

Benefits

• Reduction or elimination of cancerous lymph nodes.
• Improved prognosis and potential for increased survival rates.
• Peace of mind knowing that cancerous tissue has been removed.

Recovery

• Initial recovery involves a hospital stay of 1-2 days.
• Pain management with prescribed medications.
• Follow up with instructions on wound care and activity restrictions.
• Full recovery may take several weeks, with gradual resumption of normal activities.
• Regular follow-up appointments to monitor healing and check for recurrence.

Alternatives

• Radiation therapy: Non-invasive but may not be sufficient for extensive lymph node involvement.
• Chemotherapy: Used often in conjunction with other treatments but may not be as definitive for localized lymph node involvement.
• Targeted therapy and immunotherapy: Dependent on specific cancer types and biomarkers; less invasive but may not replace the need for surgical removal.

Patient Experience

During the procedure, the patient will be under general anesthesia and will not feel any pain. Post-procedure, patients may experience discomfort, pain at the incision site, and some difficulty with neck movements. Pain management strategies include prescribed medications and supportive care from the nursing team. With proper care, most patients adapt well and gradually return to normal activities.