Subcutaneous emphysema is mostly caused by pneumothorax. There should be a tracheal or bronchial fistula. In severe cases, oxygen saturation should be maintained as much as possible. If the pneumothorax continues to increase, it is possible to extend to the chest. The pleural cavity consists of the lining of the pleural wall and the dirty layer, which is a dense, underlying cavity that does not contain air. When the pleura is broken for any reason and air enters the pleural cavity, it is called pneumothorax. At this time, the pressure in the pleural cavity increases, and even the negative pressure becomes positive pressure, which compresses the lungs and obstructs the venous blood flow back to the heart, producing different degrees of pulmonary and cardiac dysfunction. The severity of symptoms depends on the speed of onset, the degree of lung compression and the condition of the primary lung disease. Typical symptoms are sudden onset of chest pain followed by chest tightness and dyspnea, and may include an irritating cough. This chest pain is often pins-and-needles or knife-like and is brief in duration. The irritating dry cough is caused by gas irritation of the pleura. Most patients with an acute onset, a large pneumothorax, or with pre-existing lung lesions have significant shortness of breath. Some patients have triggers such as violent cough, forceful breath-holding stool or heavy lifting before the occurrence of pneumothorax, but many patients develop it during normal activities or quiet rest. A moderate amount of pneumothorax in young healthy people is rarely uncomfortable, and sometimes patients are only detected during physical examination or routine chest fluoroscopy; whereas in elderly people with emphysema, even if the lung is less than 10% compressed, it can produce significant dyspnea. The purpose of surgery is firstly to control pulmonary air leakage, secondly to deal with pulmonary lesions, and thirdly to prevent recurrence of pneumothorax by making adhesions between the dirty layer and the wall pleura. In recent years, due to the development of thoracic surgery, mainly the improvement of surgical methods and surgical instruments, especially the advancement of TV thoracoscopic instruments and techniques, surgical treatment of spontaneous pneumothorax has become a safe and reliable method. Surgical procedures can eliminate the rupture of the lung, and can also fundamentally deal with the primary lesions, such as pulmonary maculoplasm, bronchopleural fistula, tuberculosis perforation, etc., or ensure pleural fixation through surgery. Therefore, it is an effective method to treat persistent pneumothorax and the most effective measure to prevent recurrence.