Altered lymphatic drainage following lymphadenectomy.

Radionucleotide scanning with colloidal 198Au and 99Tc sulfur colloid was used to evaluate preoperative and postoperative lymphatic drainage in 10 patients with primary malignant melanoma of the trunk. After an intradermal injection of radionucleotide aroung the primary melanoma site, tomographic scanning was performed to identify the regional lymph nodes to which the radionucleotide drained. Approximately one year following lymphadenectomy, each patient was rescanned to see if the lymphatic drainage had changed. Of the 10 patients tested, 8 had postoperative drainage patterns that differed from the preoperative scans. Three patients had no drainage to the lymphadenectomy site, which two patients retained some drainage to the lymphadenectomy sites but also showed drainage to a new site. One patient retained drainage to only one of two preoperative sites, and 2 patients had no identifiable lymphatic drainage postoperatively. Thus, interruption of lymphatic channels is temporary, and new routes that may differ from preoperative ones generally develop within one to two years.