In 1982, Mason used total lung lavage to treat a case of mixed pneumoconiosis, pioneering lung lavage in the treatment of pneumoconiosis, and in 1986, Professor Tan Guangxin was the first in China to perform this work, and in 1991, he established a new technique for the treatment of pneumoconiosis by simultaneous lung lavage of both lungs. The basic method: According to the operation protocol of large volume whole lung lavage, the basic method is that the patient is placed in the trachea and bronchus with a double-lumen catheter under intravenous compound anesthesia, and one lung is ventilated with pure oxygen while the other lung is repeatedly lavaged with 37 ℃ saline. The lungs were repeatedly lavaged with 37 ℃ saline on the other side. The volume of lavage was 500-1500 ml each time until the lavage fluid was clarified. During the lavage process, intermittent oxygen-pressure ventilation is performed, alternating with negative pressure suction. High-volume total lung lavage can not only remove dust and inflammatory and fibrogenic factors from the alveoli, but also improve the symptoms and lung function, and the patient’s symptoms will be relieved or disappear after the procedure, and the strength will increase significantly. The incidence of intraoperative and postoperative adverse effects and various complications has been reduced from 7.97% in the early stage to less than 3% in large volume whole lung lavage. Principle of action: The therapeutic mechanism of high volume total lung lavage is to target the dust and inflammatory cells that are always present in the lungs in pneumoconiosis, mainly targeting the alveolitis in the pathological process of pneumoconiosis, but not the pulmonary fibrosis. Inflammation is the first defensive reaction of the body during the development of pneumoconiosis and has an indirect effect on the formation of fibrosis later on. High-volume whole-lung lavage not only removes residual dust, macrophages, and inflammatory and fibrogenic factors from the alveoli, but also improves symptoms and pulmonary function. Early lavage removes a large number of dust cells and silica dust that can secrete fibrotic media from the patient’s alveoli, which is not only clinically effective but also helps to stop the progression of lesions and delay the escalation of pneumoconiosis, and even prevents the onset of pneumoconiosis by lavage of dust workers and suspected pneumoconiosis who have not yet developed lesions on X-ray chest radiographs, thus playing a secondary prevention role. Indications: ① All stages of pneumoconiosis are indications for lung lavage. The earlier the stage, the more dust is excreted and the better the effect, so 0+ and stage I are the best indications, followed by stage II and III. ② Age selection: for stage 0+ and Ⅰ pneumoconiosis, the age should be below 60 years old; for stage II or III, the age should be limited to below 55-50 years old accordingly. ③Good cardiopulmonary compensatory function, pulmonary function indexes reaching more than 70% of the expected value, PaO2 >10kPa, all routine laboratory tests are normal. Contraindications: ① Tracheal and bronchial malformations, resulting in incorrect seating of the double-lumen catheter. ②Patients suffering from heart, liver, kidney, blood system diseases, acute and chronic infectious diseases or other important complications. ③Pulmonary complications of active tuberculosis, acute infection, pulmonary alveoli, severe obstructive emphysema, pulmonary heart disease or other diseases that severely impair lung function.