Post-Surgery Swelling of Groin Lymph Nodes: Causes and Concerns

Postoperative swelling of inguinal lymph nodes?

Hello Dr.
Lee: I underwent a right thigh lymph node excision surgery two weeks ago, and the pathology results indicate stage II follicular lymphoma.
Since the surgery, the wound has been very swollen (about the size of a duck egg), and it is quite painful when pressed or while walking.
During my follow-up visit, the surgeon performed an ultrasound scan and found fluid accumulation inside.
They used a syringe to aspirate two vials of serous fluid, but the swelling returned to its original state just one day later, and my body has not absorbed the fluid within the wound.
I would like to ask whether the swelling and fluid accumulation are normal after excision surgery, or if the removal of the lymph nodes affects the body's ability to absorb tissue fluid, necessitating repeated visits to the hospital for aspiration of the fluid.
Thank you.

Jiefu, 40~49 year old female. Ask Date: 2023/12/13

Dr. Li Zhonghuai reply Surgery

Hello! After surgery on the lymph nodes, there may be lymphatic fluid leakage from the nearby lymphatic vessels, which can be more pronounced in cases of malignant lymph nodes.
It is recommended to consult a hematologist-oncologist for the next phase of treatment as soon as possible.
The lymphatic leakage will gradually improve.
Take care! Changhua Hospital is concerned about you!

Reply Date: 2023/12/13

More Info

Dear Patient,
Thank you for reaching out with your concerns regarding the post-surgery swelling of your groin lymph nodes following the excision of lymphadenopathy. I understand that you are experiencing significant swelling and discomfort, and I will do my best to provide clarity on this matter.

Firstly, it is not uncommon to experience swelling after lymph node surgery, particularly in the groin area. This swelling can be attributed to a few factors, including surgical trauma, fluid accumulation (seroma), and the body’s inflammatory response to the procedure. The presence of a seroma, which is a collection of fluid that can accumulate in the space where lymph nodes were removed, is a common occurrence after such surgeries. It can lead to the swelling you are experiencing, and it may cause discomfort, especially when pressure is applied or during movement.

In your case, the ultrasound revealing fluid accumulation and the subsequent aspiration of tissue fluid indicates that a seroma has formed. While aspiration can provide temporary relief, it is not uncommon for seromas to reaccumulate, as you have experienced. The body may take time to reabsorb this fluid, and in some cases, it may require repeated aspirations if the seroma does not resolve on its own.
The lymphatic system plays a crucial role in fluid balance within the body. When lymph nodes are removed, the drainage pathways can be disrupted, potentially leading to fluid buildup. This disruption can affect the body’s ability to absorb and manage tissue fluid effectively, which might explain the persistent swelling and the need for repeated aspirations.

In terms of your specific situation, it is essential to monitor the swelling closely. If the swelling continues to be significant or if you experience increased pain, redness, or fever, it is crucial to contact your healthcare provider. These could be signs of infection or other complications that may require further intervention.

As for the long-term implications, while seromas can be bothersome, they are generally not dangerous. However, if they persist, your doctor may discuss options such as compression garments or, in some cases, surgical intervention to address the fluid accumulation.

In summary, post-surgical swelling and fluid accumulation are relatively common after lymph node excision, particularly in the groin area. While it can be uncomfortable and may require repeated drainage, it is typically manageable. It is essential to maintain open communication with your healthcare team and report any changes in your symptoms.

I hope this information helps alleviate some of your concerns. Please take care, and do not hesitate to reach out to your healthcare provider for further assistance.

Best regards,
Doctor Q&A Teams

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