The timing of surgery for surgical treatment of tuberculosis should be chosen firstly to control the patient’s systemic tuberculosis toxicity symptoms through medical treatment so that the tuberculosis lesion is in a stable or relatively stable state. Any expansion of the scope of surgical treatment of tuberculosis and hasty surgery are not desirable; otherwise, more or serious complications may arise [8] [9]. For example, patients with tuberculosis combined with hemoptysis and spinal tuberculosis combined with paraplegia should be operated early [4]; however, those with irreversible lesions caused by tuberculosis or suspected lung cancer, tuberculosis combined with varicoceles, cavitary lesions and bronchial stenosis should be operated electively [3] [8] [9]; for tuberculosis combined with diabetes. Malnutrition, etc. should be adjusted to the organism status, and surgical intervention should be considered when appropriate. Jin Feng, Department of Thoracic Surgery, Shandong Provincial Chest Hospital, however, medical surgeons still have a big disagreement about the judgment of the timing of surgery [4] [7]. Prolonged and ineffective medical treatment may result in resistance to certain drugs or tuberculosis dissemination losing the opportunity for surgical treatment, and this artificial delay may even result in patients losing the opportunity for cure. Of course, premature surgery with inadequate preoperative chemotherapy may lead to increased postoperative complications such as tuberculosis dissemination, abscess chest, and bronchopleural fistula, while some of these patients may be cured by internal chemotherapy. Therefore, the timing of preoperative chemotherapy and the choice of effective drugs are the most important factors affecting the timing of surgery. The timing of surgery for multi-drug resistant TB is mainly based on the degree of drug resistance and mycobacterial counts. Some authors also use weekly monitoring of patients’ sputum smear fluorescence staining for antacid bacilli and mycobacterial counts (positive grading), and the best time for surgery is when the antacid bacilli are negative and the mycobacterial count reaches a minimum, i.e., before the mycobacterial count falls and then rises again [3]. In resected specimens from patients with a negative preoperative sputum TB test, 27%-100% of the specimens were found to be resistant to TB; one study found that the bacteria were unusually active in macrophages on the surface of the resected specimen cavity, which is also the site of new drug-resistant mutations [6]. Patients who are resistant to almost all antituberculosis drugs usually undergo surgery within one to two months of treatment to avoid rapid spread to the opposite side or even the whole body, which makes surgical treatment difficult [4]. The appropriate time for surgery for tuberculosis is 6 months after chemotherapy, when the sputum is negative, or even if the sputum is still positive, the mycobacterial count is reduced to an appropriate level, and most of the reversible lesions have healed or receded during this time [3] [4]. The treatment of TB patients is mainly medical, and surgery is only a secondary position [2]. The hand in hand cooperation between medical and surgical physicians to enhance communication and exchange is of great importance in determining the need for surgery and the best node for surgery [2] [4]. Bertolaccini [7] even suggested that the determination of whether a patient with TB can benefit from surgery should involve infectious disease specialists, respiratory physicians, radiologists and thoracic surgeons.