(1) Emergency management: place a chest tube immediately to control infection and prevent backflow of pus to the contralateral side; the patient lies on the dissected side until pleural drainage is satisfactory. If the bronchopleural fistula is large and requires mechanical ventilation, a double-lumen catheter should be inserted or a single-lumen catheter should be inserted into the contralateral side to ventilate and isolate the side with the fistula. (2) Their treatment plan includes thoracoplasty, open drainage, closure of the fistula via the posterior wall of the pericardium, elimination of the residual cavity with fluid or muscle flaps, and closure of the original fistula with sutures of tipped tissue. For frail individuals, it is recommended to perform an open drainage change, a second surgery to close the fistula, and complete healing of the fistula followed by filling the pleural cavity with antibiotic solution and closing the chest wall incision. Surgical steps: Step 1: open drainage – closure of fistula – muscle flap transfer – debridement. If the bronchial stump is short, it should be freed, opened and cleared to healthy tissue; if the bronchial stump is too long, it should be freed to the bulge and sutured to close the stump. After intermittent suturing of the bronchial stump and closure of the stump, the absorbable suture is interrupted and the muscle flap is fixed around the bronchial stump, or the muscle flap can be sutured directly to the edge of the fistula. Remove the necrotic tissue and purulent secretions from the pleural cavity, thoroughly flush the pleural cavity, and fill the pleural cavity with a large gauze block moistened with dilute solution, paying attention to a certain pressure when filling to prevent blood or fluid accumulation between the muscle flap and the stump. The chest wall incision is kept open and left unsutured. It should be noted that in open drainage, if there is less pus, muscle flap transfer is feasible; otherwise, drainage and drug exchange should be performed after 5-7 days before muscle flap transfer. The dressing should be changed every 48 hours for 4-6 days after muscle flap transfer to make the muscle flap adhere to the bronchial stump. Step 2: Elimination of the pleural cavity – closure of the chest wall incision. After step 1 surgery, the pleural cavity is clean, fresh granulation tissue, and the antibiotic solution is filled with the cavity membrane for the chest. The chest wall is sutured in layers, and the sutures should be tightly butted to prevent leakage of the solution instilled into the pleural cavity.