Evidence map›Paper›PMID 40149302›Full record

ReviewCancers2025

Resection vs. Ligation vs. Preservation of the Thoracic Duct During Esophagectomy for Cancer: A Systematic Review and Meta-Analysis.

David J Nijssen, Dillen C van der Aa, Mahsoem Ali, Geert Kazemier, Faridi S Jamaludin, Wietse J Eshuis, Mark I van Berge Henegouwen, Suzanne S Gisbertz

Abstract readReview
In one paragraph

Review in Cancers, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Observational
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

David J NijssenDepartment of Surgery, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
Dillen C van der AaDepartment of Surgery, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.ORCID 0000-0002-6954-6883
Mahsoem AliCancer Center Amsterdam, Cancer Treatment and Quality of Life, 1066 CX Amsterdam, The Netherlands.ORCID 0000-0002-0511-6323
Geert KazemierCancer Center Amsterdam, Cancer Treatment and Quality of Life, 1066 CX Amsterdam, The Netherlands.
Faridi S JamaludinMedical Library AMC, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.ORCID 0000-0002-1452-1769
Wietse J EshuisDepartment of Surgery, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.ORCID 0000-0002-0344-6695
Mark I van Berge HenegouwenDepartment of Surgery, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.ORCID 0000-0001-8689-3134
Suzanne S GisbertzDepartment of Surgery, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.ORCID 0000-0001-9655-7601

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND/

objectivesThe effect of thoracic duct (TD) management-resection, ligation, or preservation-during esophagectomy for cancer remains controversial. This systematic review and meta-analysis aimed to assess the impact of TD management strategies on oncological outcomes and surgical morbidity.

methodsA systematic review and meta-analysis were performed following PRISMA reporting guidelines. Searches of OVID, Embase, and Web of Science identified studies comparing thoracic duct resection or TD ligation with TD preservation in esophagectomy for cancer. Outcomes included 5-year overall survival (OS), postoperative morbidity, postoperative chyle leakage, lymph node yield, and length of stay. Random-effects meta-analyses using the Hartung-Knapp-Sidik-Jonkman variance correction were conducted.

resultsA total of 17 studies involving 4200 patients were included. TD resection was associated with a significantly higher lymph node yield (mean difference [MD]: 4, 95% CI: 0 to 8,

conclusionsTD resection increases lymph node yield but is associated with higher rates of chyle leakage, without a significantly improved overall survival. TD ligation does not significantly affect oncological or surgical outcomes compared to TD preservation. A higher grade of evidence is needed to determine the definitive oncological and surgical impact of TD management strategies.

Indexed as

chyle leakageesophagectomyligationmorbiditypreservationresectionthoracic duct

Identifiers

PMID40149302
PMCPMC11940447

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.