Anatomical Resection Research Articles

RTSA With Humeral Head Autograft Glenoid Reconstruction

Background: Untreated chronic massive rotator cuff tears and primary osteoarthritis can lead to conditions of significant retroversion, posterior bone loss, and humeral head subluxation. Indications: Reverse total shoulder arthroplasty with humeral head autograft glenoid reconstruction may be indicated in patients with advanced glenohumeral osteoarthritis and/or severe glenoid retroversion/bone loss due to rotator cuff arthropathy, trauma, primary, or inflammatory osteoarthritis. Technique: Besides routine radiography and preoperative computed tomography (CT) scans, 3-dimensional (3D) planning software is often performed as a routine part of preoperative planning. A 3D printed model of the glenoid can also be helpful in cases of significant bone deformity. Patients are placed in a 45° modified beach chair position. Using a standard deltopectoral approach, the glenoid is exposed. An anatomic humeral head resection is made. The contour of the articular margin of the humeral head should match the glenoid bone deficiency anatomically as it has been chronically resting within the glenoid defect. Three dimensional preoperative planning and the 3D printed model are used to make an asymmetric humeral head autograft which should match the deficiency perfectly. The articular cartilage is removed with a burr. The graft and baseplate are coupled together (metaphyseal bone facing the baseplate and prepared articular side of the graft facing native bone) and measurements are performed with the preoperative planning software to fashion a graft with the appropriate dimension and with the desired amount of lateralization. The bone graft is then compressed with the baseplate to the native glenoid and fixed with screws. Results: In select patients with careful preoperative planning, excellent outcomes can be achieved with careful gradual resumption of range of motion and strength with physical therapy. Sequential radiographic imaging is performed up to 6 months and beyond to confirm solid union of graft to native glenoid bone and incorporation into the baseplate. Discussion/Conclusion: Reverse total shoulder arthroplasty (rTSA) with humeral head autograft glenoid reconstruction is an excellent option to address severe glenoid bone loss and restore the native joint line for both primary osteoarthritis and rotator cuff arthropathy. Using 3D CT scans, 3D preoperative planning software and 3D printing of the glenoid can help achieve a good outcome. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.

Robo-Lap Approach Optimizes Intraoperative Outcomes in Robotic Left and Right Hepatectomy.

The aim of the present study is to evaluate the possible advantages of the Robo-Lap (parenchymal transection by laparoscopic ultrasonic dissector and robotic bipolar forceps and scissors) compared with pure robotic technique (parenchymal transection by use of robotic bipolar forceps and scissors) in major anatomical liver resections with specific focus on intraoperative outcomes. Major liver resections performed by robotic approach between February 1, 2021 and March 31, 2023 were stratified into two groups according to the approach used to address the phase of liver transection; Pure Robotic Group (n = 21) versus Robo-Lap Group (n = 48). The two groups were compared in terms of intra- and postoperative outcomes and in terms of rate of achievement of intraoperative textbook outcomes. Conversion rate was similar between the two groups while incidence of adverse intraoperative events (according to Satava classification) was higher in the Pure Robotic compared with the Robo-Lap group (85.7% vs 39.6%, p < 0.001). Time to perform parenchymal transection was significantly shorter in the Robo-Lap group (180 min) compared with the Pure Robotic Group (240 min), p = 0.003. Intraoperative textbook outcomes were achieved in a lower proportion of patients in the Pure Robotic compared with the Robo-Lap group. Outcomes of the present study suggest a favorable role of the Robo-Lap approach in robotic major resections as it allows an improvement of the intraoperative results, a greater probability of an uneventful conduction of the procedure, and therefore, better management of the operating room time.

Differences between Undergoing an Atypical Liver Resection vs. a Liver Anatomical Resection on Colorectal Metastases: A Retrospective Review

Differences between Undergoing an Atypical Liver Resection vs. a Liver Anatomical Resection on Colorectal Metastases: A Retrospective Review

Impact of tumor location and pleural invasion on the frequency of skip hilar lymph node metastasis in lung cancer.

The appropriate extent of hilar lymph node (LN) dissection in segmentectomy for lung cancer has not yet been fully investigated. Herein, we assessed the patterns of LN metastasis using network analyses. Patients with nodal metastases of non-small-cell lung cancer measuring ≤30 mm in diameter who underwent anatomical resection were included. The assumed pathways of metastasis were visualized using Cytoscape software. Metastasis to hilar (#10) or interlobar (#11) LNs but not to more peripheral ones was defined as skip N1 metastasis. A total of 322 patients were included, with 123 of them having pleural invasive tumors and 32 having intrapulmonary metastases. There were 130 patients with pN1 disease and 192 with pN2 disease. The overall proportion of patients with skip N1 metastasis was 17%. Patients with lower lobe tumors had more frequent skip N1 metastasis than those with upper lobe tumors (31% vs. 10%, P<0.001) but had less frequent skip N2 metastasis (10% vs. 20%, P=0.02). The rates of skip metastasis to #11i in the right S6 tumor and right S9-10 tumor were unexpectedly high (22% and 17%, respectively). Similarly, skip metastasis to #11 in the left S6 tumor was relatively high (16%). There was a significant difference in the frequency of skip LN metastasis between tumors with and without pleural invasion (44% vs. 27%, P=0.001). The pattern of LN metastasis differed according to the localized segment of the tumor and the pleural invasion status.

Evaluating three-dimensional lung reconstructions for thoracoscopic lung resections using open-source software: a pilot study.

Preoperative three-dimensional (3D) lung reconstructions can reduce intraoperative blood loss, conversion rate, and operation duration. These 3D reconstructions are predominantly provided by commercial expensive products, hence we aimed to assess the usability and performance of preoperative 3D lung reconstructions created with open-source software. Patients were invited to participate in this prospective pilot study if they were planned for uniportal video-assisted thoracoscopic surgery (VATS) lobectomy or segmentectomy between January and February 2023. Participants were excluded if a two-dimensional (2D) late-arterial-phase computed tomography (CT) scan contained motion artifacts, another surgical procedure was performed, or the surgery was canceled. After informed consent was obtained, 3D lung reconstructions were constructed using open-source 3D Slicer software. The system usability score (SUS) questionnaire assessed the usability of these reconstructions, whilst performance was evaluated based on anatomical validity compared to prior 2D CT assessment as well as operative findings. Descriptive statistics were reported. Thirteen patients were included, of whom one underwent a segmentectomy. Eighty-three percent of the 3D lung reconstructions scored above average (SUS >68). Compared to 2D CT scans, 38% of lung nodule segmental locations were detected more accurately through 3D lung reconstructions. Furthermore, 3D lung reconstructions revealed anatomical variations in 62%, which were not recognized on 2D CT scans, and provided surgeons with insights that would change the procedure and/or transection planes in 62%. One 3D lung reconstruction failed to demonstrate an intraoperative recognized segmental pulmonary artery (A6) branch. Three-dimensional lung reconstructions created with open-source software were usable and effective for uniportal VATS anatomical resections. ClinicalTrials.gov/NCT06132607.

Laparoscopic Anatomical Resection of Paracaval Portion of Caudate Lobe and Segment 8 for HCC in a HCV-related Cirrhotic Patient

Laparoscopic Anatomical Resection of Paracaval Portion of Caudate Lobe and Segment 8 for HCC in a HCV-related Cirrhotic Patient

Anatomical resection for non-small cell lung cancer: cardiopulmonary exercise testing in assessing the risk of respiratory complications

Anatomical resection for non-small cell lung cancer: cardiopulmonary exercise testing in assessing the risk of respiratory complications

ПЕРВЫЙ ОПЫТ ЛАПАРОСКОПИЧЕСКОЙ ЛЕВОСТОРОННЕЙ ЛАТЕРАЛЬНОЙ СЕКЦИОНЭКТОМИИ ПЕЧЕНИ ПО ПОВОДУ ЭХИНОКОККОЗА

Introduction. Echinococc is a biohelminthiasis that mainly affects the liver. Annually in the Republic of Belarus is registered 10–18 cases of echinococcal lesions, most of which are asymptomatic. The purpose of the study. Analysis of the results of the first experience of performing laparoscopic left-sided lateral sectionectomy in hepatic echinococcosis. Material and methods. The article presents the successful experience of treating a patient with echinococcosis of the liver, who underwent laparoscopic left-sided lateral liver sectionectomy for the first time in the Grodno University Clinic. Results. We applied laparoscopic intrahepatic isolation, hardware stitching and clipping of the glissone legs of the II and III segments of the liver, which contributed to the anatomical resection of the left lateral sector, achieving reliable hemostasis and cholestasis. No complications were observed in postoperative period. Conclusions. Laparoscopic left–sided lateral sectionectomy using intrahepatic glissone access is a safe and affordable operation in patients with echinococcal lesions of the II and III segments of the liver.

Liver resection versusliver transplantation for hepatocellular carcinoma within the Milan criteria based on estimated microvascular invasion risks.

Preoperative prediction of microvascular invasion (MVI) in hepatocellular carcinoma (HCC) may optimize individualized treatment decision-making. This study aimed to investigate the prognostic differences between HCC patients undergoing liver resection (LR) and liver transplantation (LT) based on predicted MVI risks. We analysed 905 patients who underwent LR, including 524 who underwent anatomical resection (AR) and 117 who underwent LT for HCC within the Milan criteria using propensity score matching. A nomogram model was used to predict preoperative MVI risk. The concordance indices of the nomogram for predicting MVI were 0.809 and 0.838 in patients undergoing LR and LT, respectively. Based on an optimal cut-off value of 200 points, the nomogram defined patients as high- or low-risk MVI groups. LT resulted in a lower 5-year recurrence rate and higher 5-year overall survival (OS) rate than LR among the high-risk patients (23.6% vs 73.2%, P < 0.001; 87.8% vs 48.1%, P < 0.001) and low-risk patients (19.0% vs 45.7%, P < 0.001; 86.5% vs 70.0%, P = 0.002). The hazard ratios (HRs) of LT vs LR for recurrence and OS were 0.18 (95% confidence interval [CI], 0.09-0.37) and 0.12 (95% CI, 0.04-0.37) among the high-risk patients and 0.37 (95% CI, 0.21-0.66) and 0.36 (95% CI, 0.17-0.78) among the low-risk patients. LT also provided a lower 5-year recurrence rate and higher 5-year OS rate than AR among the high-risk patients (24.8% vs 63.5%, P = 0.001; 86.7% vs 65.7%, P = 0.004), with HRs of LT vs AR for recurrence and OS being 0.24 (95% CI, 0.11-0.53) and 0.17 (95% CI, 0.06-0.52), respectively. The 5-year recurrence and OS rates between patients undergoing LT and AR were not significantly different in the low-risk patients (19.4% vs 28.3%, P = 0.129; 85.7% vs 77.8%, P = 0.161). LT was superior to LR for patients with HCC within the Milan criteria with a predicted high or low risk of MVI. No significant differences in prognosis were found between LT and AR in patients with a low risk of MVI.

Preoperative PET-SUVmax and volume based PET parameters of the primary tumor fail to predict nodal upstaging in early-stage lung cancer

ObjectivesAccurate nodal staging is of utmost importance in patients with lung cancer. FDG-PET/CT imaging is now part of the routine staging. Despite thorough preoperative staging nodal upstaging still occurs in early-stage lung cancer. However, the predictive value of preoperative PET metrics of the primary tumor on nodal upstaging remains to be unexplored. Our aim was to assess the association of these preoperative PET-parameters with nodal upstaging in histologically confirmed lung adenocarcinoma and squamous cell carcinoma. MethodsFrom January 2016 to November 2018, 500 patients with pT1-T2/cN0 lung cancer received an anatomical resection with curative intent. 171 patients with adenocarcinoma and squamous cell carcinoma and available PET-CTs were retrospectively included. We analyzed the the association of nodal upstaging with preoperative PET-SUVmax and metabolic PET metrics including total lesion glycolysis (TLG) and metabolic tumor volume (MTV) with different defined thresholds. ResultsHigh values of preoperative PET-SUVmax of the primary tumor were associated with squamous cell carcinoma (p < 0.0001) and with larger tumors (p < 0.0001). Increased preoperative C-reactive protein levels (<1mg/dL) correlated significantly with high preoperative PET-SUVmax values (p < 0.0001). No significant relationship between PET-SUVmax and lactate dehydrogenase activity (p = 0.6818), white blood cell count (p = 0.7681), gender (p = 0.1115) or age (p = 0.9284) was observed. Nodal upstaging rate was 14.0 % with 8.8 % N1 and 5.3 % N2 upstaging. Tumor size (p = 0.0468) and number of removed lymph nodes (p = 0.0461) were significant predictors of nodal upstaging but no significant association was found with histology or PET parameters. Of note, increased MTV – regardless of the threshold – tended to associate with nodal upstaging. ConclusionEarly-stage lung cancer patients with squamous histology and T2 tumors presented increased preoperative PET-SUVmax values. Nevertheless, beyond tumor size and number of removed lymph nodes neither SUVmax nor metabolic PET parameters MTV and TLG were significant predictors of nodal upstaging.

Ten-year experience in the clinical management of intralobar pulmonary sequestration in children.

Intralobar pulmonary sequestration (ILS) is rare and its optimal clinical management remains ambiguous. This study aimed to introduce our 10-year experience in clinical management of ILS. And the application of our novel surgical method, thoracoscopic anatomical lesion resection (TALR) on ILS was introduced. Patients with ILS who received treatment between December 2010 and2020 were included in this study, retrospectively. A binary logistic regression model was used to assess risk factors for preoperative symptoms. Intraoperative and postoperative outcomes were compared between the thoracoscopic lobectomy and lung-sparing surgery groups. A total of 112 patients were included in this study. Age and maximum cyst diameter were risk factors for preoperative symptoms. Lung-sparing surgery proved to be safe and feasible with no residual lesions. The overall prognosis of early thoracoscopic surgery for ILS was good. Lung-sparing surgery, especially TALR could be used as a first-line surgery for ILS. It may resolve the long-standing controversy over whether surgery for asymptomatic patients with ILS.

Application of three-dimensional computed tomography imaging and reconstructive techniques in lung surgery: A mini-review.

Pulmonary surgery is an innovative discipline with increasing demands for minimally invasive techniques in complicated anatomical resections, warranting adequate preoperative imaging of relevant surgical anatomy to ensure safe and radical resection of target lesions. Over the recent years, the emergence of imaging techniques enabling three-dimensional reconstruction has exerted promising influence on pulmonary surgery, facilitating optimal surgical planning and easier identification of the spatial relationship between bronchovascular structures in the individual patient and aiding the safe resection of target pulmonary lesions. The goal of this mini-review is to provide an overview of three-dimensional computed tomography imaging within pulmonary surgery. The authors performed a targeted qualitative review of the literature to identify current trends and to provide better understanding of three-dimensional reconstruction within the boundaries of pulmonary surgery. Three-dimensional reconstructive techniques can be used for resectability assessment, identification of surgically relevant interindividual anatomic variance and may improve perioperative outcomes. Three-dimensional reconstruction using computed tomography imaging improves surgical planning and there is evidence that it results in shorter operative times, less intraoperative blood loss and lower rates of surgical conversion, as it can be applied both pre- and intraoperatively.

Significance of preoperative evaluation of skeletal muscle index and immune-nutritional status for patients with early-stage non-small cell lung cancer.

Sarcopenia involves several mechanisms, including age-related changes, nutritional deficiencies, and inflammation, and is associated with unfavorable clinical outcomes. However, the significance of skeletal muscle index (SMI) and immune-nutritional status for patients with early-stage non-small cell lung cancer (NSCLC) remains unclear. This retrospective study was performed to investigate associations between preoperative SMI based on computed tomography (CT) at the L1 level and immune-nutritional status, and whether these factors correlated with surgical outcomes. We retrospectively investigated 386 patients with stage I-II NSCLC who underwent curative anatomical pulmonary resection. SMI was assessed on CT at the L1 level and patients were divided into low-SMI (n = 97) and high-SMI (n = 289) groups. We examined the significance of SMI for postoperative outcomes and evaluated correlations between SMI and clinical characteristics, including immune-nutritional status. Low SMI was significantly associated with body mass index and geriatric nutritional risk index. Five-year overall survival rate was significantly lower in the low-SMI group (66.0%) than in the high-SMI group (82.2%, P = 0.004). Multivariate analysis revealed SMI (hazard ratio [HR] 1.850; 95% confidence interval [CI] 1.091-3.135; P = 0.022) and prognostic nutritional index (PNI) (HR 2.031; 95% CI 1.231-3.352; P = 0.006) as independent predictors of overall survival. Low SMI correlated significantly with postoperative complications (P = 0.024). Low preoperative SMI based on CT at the L1 level appears associated with poor prognosis and postoperative complications among patients with early-stage NSCLC. PNI is also an independent prognostic factor for surgical outcomes.

Risk factors for long-term decline in post-operative pulmonary function after lung resection.

The study aimed to examine the risk factors for long-term decline in pulmonary function after anatomical resection for lung cancer and the effects of the decrease on survival. We retrospectively examined 489 patients who underwent anatomical resection for lung cancer between 2010 and 2020. Pulmonary function tests were performed preoperatively and at 1, 3, 6 and 12months after surgery. The lower interquartile medians of the reduction rates of forced expiratory volume in 1s and vital capacity at 12months after surgery were taken as the cut-off values of risk factors for the decrease in post-operative pulmonary function. Forced expiratory volume in 1s and vital capacity decreased the most in the first month after surgery and then gradually recovered. Vital capacity continued to increase even after 6months post-surgery, whereas forced expiratory volume in 1s stabilized. Multivariable logistic analysis showed that the number of resected segments (odds ratio, 2.09; 95% confidence interval, 1.12-3.89; P=0.019) was a risk factor for the decrease in forced expiratory volume in 1s at 12months, and the numbers of resected segments (odds ratio, 1.36; 95% confidence interval, 1.13-1.63; P<0.001) and post-operative complications (odds ratio, 2.32; 95% confidence interval, 1.01-5.35; P=0.047) were independent risk factors for decrease in vital capacity. Multivariate cox regression analysis showed that the decrease in vital capacity at 12months was significantly associated with overall survival (hazard ratio, 2.02; 95% confidence interval, 1.24-3.67; P=0.004). Long-term decrease in vital capacity, which was influenced by the number of resected segments and post-operative complications, adversely affected survival.

Letter to the editor referencing Effect of inspiratory muscle training associated or not to physical rehabilitation in preoperative anatomic pulmonary resection: a systemic review and meta-analysis.

The recent systematic review and meta-analysis by de Oliveria Vacchi, Martha, and Macagnan (2022) on the effect of inspiratory muscle training (IMT) and its association with physical rehabilitation in preoperative anatomic pulmonary resection raises some interesting findings, and the authors should be congratulated for their work. However, additional factors should be considered in the context of this study. These include frailty, postoperative pulmonary complications, and the high correlation between lung cancer and chronic obstructive disease. This study is paramount considering the potential to improve patient suitability for curative surgery, the high risks associated with surgery and shifting demographics with an increased prevalence of comorbidities, alongside fiscal pressures. This study suggests the need for further high-quality research in this high-risk population, considering IMT alone or with physical rehabilitation, with methodologies that are reproducible.

Minimally invasive surgery for hepatocellular carcinoma

Aim. To evaluate outcomes of laparoscopic liver resections in patients with hepatocellular carcinoma (HCC).Materials and methods. 40 endovideosurgical liver resections were performed in patients with HCC in the period of 2011–2021. Concomitant cirrhosis was detected in 36 cases (90%).Results. The average duration of surgery was 158.1 ± 78.6 min. The duration of anatomical lobar resections appeared to be the longest – 230 min. The average volume of intraoperative blood loss was 259.5 ± 260.5 ml, which almost excluded blood transfusions. The duration of hospitalization comprised 11.2 ± 2.3 days. One-year survival was achieved in 95% of cases, two-year – in 81%, three-year – in 64%.Conclusion. Laparoscopic liver resections in hepatocellular carcinoma prove to be safe and provide satisfactory surgical and oncological outcomes.

A Multicenter Retrospective Cohort Study on Superior Vena Cava Resection in Non-Small-Cell Lung Cancer Surgery.

Surgery for non-small-cell lung cancers (NSCLCs) invading the superior vena cava (SVC) is rarely performed due to surgical complexities and reported poor prognoses. Different methods have been described to reconstruct the SVC, such as direct suture, patch use or prosthesis, according to its circumferential involvement. The aim of our study was to analyze the short- and long-term results of different types of SVC resection and reconstruction for T4 NSCLCs. Between January 2000 and December 2019, 80 patients received an anatomical lung resection with SVC surgery in this multicenter retrospective study. The partial resection and direct suture or patch reconstruction group included 64 patients, while the complete resection and prosthesis reconstruction group included 16 patients. The primary endpoints were as follows: long-term survival and disease-free survival. The secondary endpoints were as follows: perioperative complications and 30- and 90-day mortality. Unpaired t-tests or Mann-Whitney U tests for non-parametric variables were applied to discrete or continuous data, and the chi-square test was applied to dichotomous or categorical data. Survival rates were calculated using the Kaplan-Meier method and compared using the log-rank test. No differences were found between the two groups in terms of general characteristics and surgical, oncological and survival outcomes. In particular, there were no differences in terms of early (50.0% vs. 68.8%, p = 0.178) and late complication frequency (12.5% vs. 12.5%, p = 1.000), 30- and 90-day mortality, R status, recurrence, overall survival (33.89 ± 40.35 vs. 35.70 ± 51.43 months, p = 0.432) and disease-free survival (27.56 ± 40.36 vs. 31.28 ± 53.08 months, p = 0.668). The multivariate analysis demonstrated that age was the only independent predictive factor for overall survival. According to our results, SVC resection has good oncological and survival outcomes, regardless of the proportion of circumferential involvement and the type of reconstruction.

Bilateral staged anatomic lung resection for bronchiectasis and infected polycystic disease complicated by bleeding: viability with 3 hypertrophied segments maintained

Bilateral lung resections are performed for various pathologies: pulmonary emphysema, parasitic diseases, metastatic lesions, and bronchiectasis. In clinical practice, sequential or staged interventions are more common. Surgical treatment of bronchiectasis is currently carried out only in cases with complications of localized forms and, as a rule, consists of resection of the affected part of the lung. The percentage of such patients is not large and amounts to about 5%. Taking into account the chronic course of bronchiectasis and certain successes of the conservative treatment, indications for resection operations may arise at different periods of the patient’s life. Sometimes, up to several decades can pass between the surgeries. Aim. To demonstrate a rare clinical case of staged lung resection for bronchiectasis in a patient who had 4 lung lobes removed with an interval of 52 years. Results. History of the disease was described. Indications for staged surgical interventions were identified. The main characteristics of the health status after the surgeries were described. Conclusion. The presented case illustrates the place and role of surgical methods in the treatment of bronchiectasis, as well as the compensatory capabilities of the lung tissue in the case of staged resection interventions.

A precise glossectomy for tongue cancer adjacent to or crossing the midline: a novel anatomical unit resection surgery

Previous studies have lacked a clear anatomical and functional definition of glossectomy for tongue cancer adjacent to or crossing the midline (TCML). The aim of this study was to provide a novel surgical approach based on anatomical unit resection surgery to treat TCML. A total of 120 patients with TCML who had undergone radical surgery were recruited retrospectively into the study. The patients who were treated with compartment surgery formed the control group; those treated with anatomical unit resection surgery formed the experimental group. The TCML was classified into cancer adjacent to the midline, cancer invading but not breaching the contralateral musculus verticalis linguae–genioglossus complex (MGC), and cancer breaching the contralateral MGC. No significant difference in the overall survival rate was found between the experimental and control groups overall (P = 0.853) or by TCML classification. In patients with cancer adjacent to the midline, the swallowing score (P = 0.040) and cosmetic outcome (P = 0.015) were significantly better in the experimental group than in the control group. For patients with cancer invading but not breaching the contralateral MGC, the speech intelligibility score (P = 0.001), swallowing score (P = 0.002), and cosmetic outcome (P = 0.037) were significantly better in the experimental group than in the control group. Anatomical unit resection surgery was found to provide a precise surgical treatment to address tongue cancer adjacent to or crossing the midline and maximally maintain tongue tissue and function.

OGC P33 Prognostic significance of tumour burden and operative technique for metachronous pulmonary metastasis from oesophageal cancer: a systematic review and meta-analysis

Abstract Background Disease recurrence following treatment for oesophageal cancer (OC) remains common despite incremental gains from neoadjuvant chemotherapy. The lung is a common site of distant metastasis following definitive OC treatment. Tumour burden influences the surgical approach utilised in the treatment of pulmonary metastasis from OC. In turn, this impacts patient prognosis. This systematic review sought to identify the impact of tumour burden and surgical approach on 5-year survival following metastectomy of metachronous pulmonary metastasis from OC. Methods A search of the major reference databases (PubMed, Medline, Cochrane) was performed with no time limits up to March 2022. Results were screened in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies reporting on the number of metastatic pulmonary tumours and operative techniques utilised were included. A random effects meta-analysis model was used to compare the impact of number of metastatic pulmonary deposits (single vs multiple), and operative approach (wedge vs anatomical resection) on the 5 year survival of patients following metastectomy for metachronous pulmonary metastasis from OC. Results Seven non-randomised studies comprising 142 patients undergoing pulmonary metastectomy for metastatic oesophageal cancer were included. The number of metastatic deposits (single vs multiple) did not affect 5-year survival (Risk Ratio = 1.08; 95% confidence interval 0.58–2.02; p = 0.81). With respect to surgical technique, anatomical resection did not confer a survival benefit compared to wedge resection of pulmonary metastases from OC (Risk Ratio = 1.33; 95% Confidence Interval: 0.81–2.19; p = 0.26). Conclusions Tumour burden and surgical technique utilised does not impact upon the prognosis of patients undergoing pulmonary metastectomy for metastatic oesophageal cancer. However, current evidence from smaller non-randomised studies remains weak owing to variation in the clinicopathological features of the primary OC and pulmonary metastasis, limiting outcome assessment.