What is a spontaneous pneumothorax? And what is pleural fixation? The chest cavity contains the heart, lungs and other organs that are protected by the chest wall. There is a membrane on the surface of the heart and lungs and on the surface of the chest wall called the pleura – the one wrapping the heart and lungs and other organs is called the dirty pleura, and the one lining the inner surface of the chest wall is called the wall pleura – and encloses a cavity, the pleural cavity. Spontaneous pneumothorax is a medical emergency with various clinical manifestations caused by the rupture of alveoli and dirty pleura, which causes the gas in the lung to leak out and accumulate in the pleural cavity, and then compress the lung to make it atrophy, which can lead to sudden death in critical cases. Spontaneous pneumothorax can be cured by bed rest, thoracentesis, closed drainage and other measures. However, there are still a few pneumothoraces that do not heal for a long time or recur within a short time after healing due to the underlying lung lesions or multiple and complex lesions, thus increasing the physical and mental pain and economic burden to patients. For the treatment of refractory pneumothorax that does not heal for a long time or recurs in a short period of time after healing, surgical methods can be used, and it is more advocated that the preferred medical method – pleural fixation – is to permanently close the “valve” of air leakage “. Surgical procedures are mostly performed by ordinary open-heart surgery or thoracoscopic surgery with multiple small incisions to perform rupture repair and resection of diseased lungs. The significant disadvantages are: painful for the patient; more complicated operation, often also doing local pleural fixation; expensive; many complications (chest infection, abscess chest, destruction of lung function, etc.); still the possibility of recurrence, etc. Pleural fixation in internal medicine is the best way to treat refractory pneumothorax that does not heal for a long time or recurs within a short time after healing, especially for bilateral pneumothorax. The disadvantage is that it can lead to pleural hypertrophy (in fact, only reinforcement of the pleura can prevent the recurrence of pneumothorax) and possible minor ventilation dysfunction. The advantages are: less pain for the patient; simpler operation; lower cost; fewer complications; and no recurrence. The principle of pleural fixation is to prevent recurrence of pneumothorax by injecting an appropriate amount of pleural fixative into the pleural cavity on the basis of closed drainage by catheter, so that the entire pleura is fixed intact and uniformly, excluding the time bomb that may detonate at any time. Pleural fixation, the nemesis of recurrent and refractory pneumothorax.