With the aging process in China, the inevitable incidence of geriatric diseases has also increased significantly. In terms of thoracic surgeons, we are encountering more and more lung cancer patients of advanced age or even super advanced age. Due to the reduced immunity, poor body response, reduced function of important organs such as heart, liver, lungs and kidneys, as well as the tendency to suffer from many chronic diseases, especially chronic obstructive pulmonary disease, coronary heart disease, diabetes, hypertension, cerebrovascular disease and other chronic diseases, the compensatory function of the body is significantly reduced, and the tolerance to surgical trauma, anesthesia, hypoxia and blood loss is poor. Faced with all these problems, thoracic surgeons all over the world have not sat idly by. With the skilled use of various minimally invasive surgical techniques, the improvement of preoperative evaluation and postoperative intensive care techniques, as well as the development of anesthesia techniques and multidisciplinary comprehensive treatment, all these advances in medical technology have brought gospel to the majority of senior lung cancer patients. Surgery is the treatment of choice for lung cancer patients. Before surgery, a comprehensive understanding of the functional status of heart, lung, liver, kidney and other organs is needed. As long as the systemic condition allows, one should actively cooperate with the surgeon and make adequate preoperative preparation for surgical treatment so that the patient can fully benefit. By caution, we mean adequate preoperative evaluation and preoperative preparation. Based on the information of chest X-ray, chest radiograph, CT and fiberoptic bronchoscopy, the possibility of surgical resection should be analyzed comprehensively to avoid pure exploration. Brain CT, bone isotope scan, abdominal ultrasound or CT for the presence of metastases in brain, bone and adrenal gland. If there is distant metastasis, it is generally considered as a contraindication except for emergency surgery such as hemoptysis. Pulmonary function is also a key factor in deciding whether surgery can be performed. Pulmonary function indicators for various pulmonary resections are generally considered to be: total pneumonectomy; lobectomy; segmental or wedge resection. However, a comprehensive analysis of pulmonary function is also necessary. Patients with long-term smoking and COPD may have some degree of improvement when lung function is measured repeatedly after 2 weeks of active treatment and functional exercise. In patients with pulmonary maculopathy, extensive pleural fibrosis, huge tumor compressing lung tissue or main bronchial opening tumor obstruction, etc., the lung function will be improved instead after resection of the diseased lung with healthy lung compensation. The measurement of the ventilation function and pulmonary ventilation blood flow of the divided lung can help to determine the function of the diseased lung. In view of the poor mobility and poor human-computer cooperation of elderly patients, especially in the case of elderly lung cancer combined with lobar and segmental dysplasia, obstructive pneumonia, pulmonary sepsis, and fear of hemoptysis, the determination of pulmonary function cannot fully meet the actual situation of the patient, so the clinical functional status, including the ability to perform daily activities, stair climbing test, and breath-holding test, should be emphasized. Holding the breath for more than 30s and ascending 5 floors within 2min indicates that the patient can withstand lobectomy.