Learning About Retroperitoneal Lymph Node Dissection and Your Diet

Retroperitoneal lymph node dissection is surgery to remove lymph nodes from behind the belly. This surgery is often done to check for or treat cancer, most often testicular cancer.

Because the surgery occurs near the body's lymphatic vessels, it can sometimes cause a chyle leak. This happens when fluid from the lymphatic system leaks into the belly after surgery. This is a known problem that can be managed. A special low-fat diet is often the first treatment your doctor will try.

Eating a low-fat diet helps cut down on the fluid your lymphatic system makes. This gives the leak time to heal on its own.

Regular dietary fat is called a long-chain triglyceride, or LCT. Your body absorbs LCTs through the lymphatic system. Eating LCTs can make a chyle leak worse because they add more fluid to the system that is trying to heal.

Medium-chain triglyceride (MCT) oil works in a different way. Your body absorbs it directly into the blood instead of through the lymphatic system. So it doesn't add to the leak. Doctors often suggest using MCT oil in place of regular cooking oil during recovery. You can cook with it or add it to soups, sauces, or smoothies.

This diet is low in fat and high in protein, with MCT oil used as the main source of fat.

Foods that are generally allowed include lean proteins, MCT oil, and other foods that are naturally low in fat.

Foods to limit or avoid include:

• Regular cooking oils and butter.
• Fatty cuts of meat.
• Fried foods.
• Full-fat dairy products.
• Nuts and nut butters.
• Other foods high in LCT fat.

This diet is stricter than a typical low-fat diet. Even small amounts of regular fat can slow healing. It is important to follow your doctor's guidance closely.

Read nutrition labels closely to check the total fat content of packaged foods. It also helps to work with a dietitian, who can plan meals that meet your needs while on this diet.

If you follow this diet for a long time, you may need a supplement. A very low-fat diet can lead to low levels of certain vitamins.

The diet is usually needed for several weeks, until the leak heals. Your doctor will let you know when it is safe to go back to a regular diet.