Destroyed lung is extensive and irreversible pulmonary parenchymal damage after chronic infection and may cause recurrent infection, hemoptysis, respiratory failure, and death. The relative outcomes of resection and nonresection management remain uncertain Methods: PubMed, Scopus, Cochrane CENTRAL, ScienceDirect, and Google Scholar were searched for adult studies published from January 2005 through 30 October 2025. Observational studies were assessed with the Newcastle-Ottawa Scale. Single-arm proportions were pooled separately for operative and conservative cohorts using fixed- or random-effects models, and clinically heterogeneous pulmonary-function outcomes were synthesized narratively Results: Fourteen observational studies involving 9,060 participants were included; 11 contributed to quantitative synthesis. Pooled long-term mortality was 0.10 (95% confidence interval [CI] 0.05-0.15) after pulmonary resection and 0.22 (95% CI 0.13-0.32) with conservative management. Pooled overall complications were 0.27 and 0.44, recurrent pulmonary infection was 0.14 and 0.44, respiratory failure was 0.04 and 0.43, and short-term mortality was 0.05 and 0.43, respectively. Pulmonary-function evidence was too heterogeneous for pooling Conclusion: Pulmonary resection was associated with lower pooled mortality and morbidity among selected surgical candidates. Because all evidence was observational and comparisons were predominantly indirect, the findings support individualized multidisciplinary selection rather than routine surgery for all patients