Cancerous pleural fluid is one of the common complications of progressive lung cancer. The traditional treatment methods are mostly thoracentesis (or closed chest drainage) followed by intracavitary injection of sclerosing agents, immunosuppressants and anticancer drugs, with different efficacy reports. From January 2005 to January 2007, our department treated 8 patients with lung cancer pleural fluid with thoracoscopic biopsy and thoracic thermal perfusion with remarkable efficacy. 1.Data and methods 1.1.Clinical data There were 8 cases in this group, 5 males and 3 females, aged 38-69 years, with a median age of 56 years. There were 7 cases of unilateral pleural fluid, 1 case of bilateral pleural fluid, 3 cases of massive pleural fluid (more than 2000 ml), 4 cases of moderate pleural fluid, and 1 case of small amount of pleural fluid (less than 1000 ml). There were 4 cases of adenocarcinoma of the lung, 2 cases of squamous carcinoma, 1 case of large cell carcinoma, and 1 case of small cell lung carcinoma. 8 patients had preoperative examinations in the normal range, CT or X-ray films all suggested occupying lung lesions and pleural effusion (malignant), Karnofsky scores were above 60, and they were able to tolerate surgery, and all had indications for surgery: lung cancer with cancerous pleural fluid; diffuse cancerous dissemination of the pleura. 1.2, Special items preparation Constant temperature water bath, thermometer, TV monitoring system, TV thoracoscopic instruments, one set of conventional closed chest drainage device. 1.3 , Methods After obtaining the consent of the patients and their families, all 8 patients were put under general anesthesia with double-lumen tracheal intubation and 90° in the healthy-side lying position. A 1.5-cm-long incision was made at the 7th intercostal space in the axillary midline, and a 10.5-mm Troca was inserted into the chest cavity after blunt dissection with a vascular clamp. A 0.8 cm and 1.5 cm incision was made in the anterior axillary line and the 4th or 5th intercostal space in the posterior axillary line under the guidance of thoracoscope. 5.5 mm and 10.5 mm Troca were inserted after blunt separation into the thoracic cavity with vascular forceps. If the pathology of the pleural biopsy is clearly malignant, the thoracic thermal perfusion procedure will be started. A thermometer was placed in the anterior axillary line incision to monitor the water temperature in the chest cavity in real time, requiring an error of ≤0.5℃. Under the supervision of thoracoscopy, a preheated 43℃ suction device (about 2m outside the surgical bed and immersed in an external 43℃ thermostatic water bath) was used to inject hot distilled water at a temperature of about 43℃ into the thoracic cavity from the roof of the thoracic cavity as far as possible. The same method was used to inject the same temperature and volume of hot distilled water into the thoracic cavity from the direction of the costo-diaphragmatic sinus, maintaining the water temperature in the thoracic cavity at 43±0.5℃ for 30 minutes, aspirating the perfused fluid after the end of hot perfusion, dispersing 100ml of saline containing cisplatine (DDP) 60mg at 43℃ evenly into the thoracic cavity, and placing a One chest tube was placed and clamped closed (opened after 1h), while the remaining two incisions were closed and the patient was placed in the supine position. After awakening from anesthesia, the patient was sent back to the ward and treated symptomatically. The GP regimen (Gemzar 1000mg/m2 d1,8; DDP40mg/m2 d1-3 q21days×4-6) chemotherapy was administered 1 week after surgery. 1.4, efficacy assessment criteria [3]: the effusion in the chest cavity was completely absorbed, the symptoms disappeared, and no pleural effusion was seen on chest X-ray or B-ultrasound examination, and maintained for more than 30 days. Effective (PR): The amount of pleural effusion is reduced by more than half after treatment, and the symptoms are improved, and the effective maintenance is more than 30 days, and no fluid extraction is required. The total effective rate was CR+PR. 2, results 2.1, perfusion fluid inflow and outflow and temperature changes in the total amount of chest perfusion fluid in the range of 3000-4000ml (average 3500ml), the temperature in the range of 42.0℃-43.0℃ (average 42.7℃), the total amount of chest perfusion fluid outflow in the range of 2910-3940 ml (average 3460 ml), the temperature in the range of 39.1℃-42.2℃ (average 41.1℃). The total perfusion time ranged from 60 to 67 min (mean 64 min). The extubation time was from 2 to 5 days (average 3 days) after the thoracic thermal perfusion chemotherapy. 2.2, post-perfusion efficacy All 8 patients were treated with only one thermal perfusion, and the total efficiency of pleural fluid control (CR+PR) reached 100%, including CR 50.0% (4/8), PR 50.0% (4/8), NR 0. The follow-up ranged from 2 months to 2 years, and there was no recurrence of postoperative pleural fluid in the whole group. 2.3, Adverse reactions after perfusion Within 12 hours after the end of perfusion, all patients had profuse sweating, hot flashes, flushing of the thoracic and facial skin, elevated body temperature (all below 38°C), and increased heart rate. 30% of patients developed supraventricular tachycardia, which was relieved by symptomatic treatment. 2.4. After perfusion, the quality of life of the patients improved significantly, and the Karnofsky score increased by more than 10 points compared with that before perfusion.