Evaluating Diagnostic Excisional Biopsy for Cervical Lymphadenopathy: Complication Rates and Histopathological Findings in Baghdad Teaching Hospital
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Abstract
Background: While needle biopsy is often used in the evaluation of lymphadenopathy, lymph node excision is frequently necessary, particularly for lymphoma diagnosis.
Lymph node excision is an invasive technique that has a possible risk of complications. However, there is limited research assessing the prevalence, types and factors associated with such complications.
Aim of Study: To identify the causes of cervical lymphadenopathy which need excisional
biopsy. To identify whether the choice for local or general anesthesia will have any impact on complications.
Patients and methods: This is a prospective study that has been conducted at the 5th surgical unit of Baghdad Teaching Hospital/ Medical city. The data was collected from the 1st of March 2023 to the 1st of October 2024. A total number of 157 patients who were referred from the outpatient clinics or from the hematology department for cervical nodal excision. Patients basic characteristics were recorded (age, gender, BMI). Moreover, a thorough clinical history was taken regarding history of neck lump and previous malignancy, and the indication for excision.
Patients were sent for the following blood investigations and imaging. Patients were followed up for 1 week post operatively to detect any local complications and the biopsy result were obtained from histopathological lab by the researcher.
Results: Regarding final histopathological diagnosis; Hodgkins lymphoma was the most common (41.4%), followed by reactive lymphadenopathy (24.8%), TB (12.7%), and non-Hodgkin’s lymphoma (6.4%). Among 157 patients, only 12 (7.6%) had complications. Regarding the type of complications, 7 (44.5%) had local swelling, 4 (2.5%) had local infection, and 1 (0.63%) had both local swelling and stitch sinus. No significant association was detected between the presence of complications and each of age, sex, BMI, neck level, and type of anesthesia.
Conclusion: The results of this study indicate that cervical lymph node excision is a low-risk procedure with a minimal incidence of complications. When complications do arise, they are typically of a minor nature. Local anesthesia was not associated with an increased risk of postoperative complications.
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