The anti-TB treatment in internal medicine for long-term bacillary and drug-resistant tuberculosis cavities often ends in failure, making some patients lose the opportunity of surgery for extensive dissemination in both lungs and become lifelong bacillary receptors, which is extremely harmful to the surrounding population and society. 1.1, General data: From July 2003 to June 2006, 28 patients with cavitary pulmonary tuberculosis were admitted to our department, 20 males and 16 females, aged 19-63 years, average 41 years, with a disease duration of 3 months-11 years. The main symptoms at the time of consultation were low-grade fever, cough, sputum, intermittent and repeated hemoptysis, and chest pain. All 28 cases in this group had a clear diagnosis of secondary tuberculosis before surgery, including 12 cases on quadruple or quintuple regular medication, 16 cases on informal medication, and 9 cases on drug-resistant medication, with a duration of 18 months-7 years. There were 8 cases of thin-walled cavity, 5 cases of fibrous thick-walled cavity and 3 cases of cheese cavity in the imaging examination, among which 2 cases had typical spherical shadow in the cavity and a crescent-shaped translucent area between the sphere and the inner wall of the cavity, and 7 cases were positive for sputum bacteria. All 28 cases in this group had no complications after surgery, and regular anti-tuberculosis treatment was continued for 9-12 months after surgery, and all 28 patients had sputum negative at follow-up. 1.2 Indications for surgery: cavitary pulmonary tuberculosis with poor results of medical treatment and one of the following conditions ① cavitary pulmonary tuberculosis with positive sputum bacilli, and the cavity cannot be closed after more than 1 year of anti-tuberculosis treatment, or those with persistent positive sputum bacilli after 6 months of regular anti-tuberculosis treatment and resistant to anti-tuberculosis treatment; ② cavity confined to one lobe of the lung; ③ cavitary pulmonary tuberculosis with recurrent hemoptysis and purulent infection, and sputum bacilli (3) recurrent hemoptysis and purulent infection of cavitary pulmonary tuberculosis with persistent positive sputum for more than 1 year; (4) stable remaining lung lesions who can tolerate general anesthesia with tracheal intubation. 1.3, Surgical procedure: All patients were intubated with double-lumen endotracheal tube, 1 case of apical posterior segment of upper lobe plus dorsal segment of lower lobe, 2 cases of segmental lung resection, 20 cases of single lung lobectomy, 2 cases of lower middle lobe resection, 1 case of left total pneumonectomy, and 2 cases of single lung lobectomy plus local thoracoplasty. 1.4, postoperative pathology: 8 cases of fibrous cavity, 2 cases of multiple cavities, 6 cases of caseous necrotic material in the cavity, 2 of which had the formation of varicocele in the cavity. The pulmonary tuberculosis spheres were pathologically confirmed. For patients with cavitary tuberculosis who are still sputum positive by medical treatment, they not only pose a threat to the surrounding population, but also can cause the spread of their own tuberculosis foci and lose the time for surgery. Surgery, as part of tuberculosis treatment, is still an effective means of treatment in China to eliminate the source of infection and address the failure of drug treatment and serious sequelae in some tuberculosis patients. In cases where long-term or irregular chemotherapy has failed, the rate of drug resistance of tuberculosis bacilli is high and surgical complications are high, so patients with tuberculosis who are not cured after a certain course of treatment and whose condition is suitable for surgical treatment should be persuaded to transfer to surgery without losing time to avoid losing a powerful opportunity. Some tuberculosis cavities are often followed by mycobacterial infection, forming pulmonary aspergillosis, and recurrent hemoptysis, such lesions are no longer worthy of continued anti-tuberculosis medication, and should be treated surgically. If it is difficult to distinguish between cavitary tuberculosis and cancerous cavity, early surgical investigation should also be performed to avoid delaying the disease. From the epidemiological point of view, surgical treatment of cavitary tuberculosis is of great significance in eliminating the source of infection for such patients.