Do patients with lung masses need surgery? Is there a chance of surgery? What kind of surgery is needed? It depends on the nature and localization of the mass, the presence or absence of distant metastases, and the basic functional status of each organ (especially the heart and lungs). The main purpose of the preoperative examination is to make a clear diagnosis, determine whether there is any metastasis, and determine whether the patient’s heart, lungs, and other organs are functioning well and can tolerate the surgery. After completing the examination, all the professors in our department will discuss together whether the patient should undergo surgery, how to carry out surgical treatment, how big the surgical risk is, and how to avoid surgical complications. I. Judging the nature and local condition of the mass 1. Chest X-ray examination: chest X-ray is the first choice and the most basic examination method. Through X-ray examination, the location and size of lung cancer can be understood. 2. Chest CT scan: it is recognized as the first choice of cross-sectional examination for patients with lung mass, CT scan can provide more information than chest radiographs in detecting smaller or hidden lesions, helping qualitative diagnosis and accurate staging, and chest enhanced CT scan can identify large blood vessels and lymph nodes more effectively. 3.Fiberoptic bronchoscopy: Fiberscope examination can directly observe the changes of tissues, take tissues for pathological section examination, or suck bronchial secretion for cytological examination, in order to clarify the diagnosis and determine the histological type. Meanwhile, fiberoptic microscopy can understand the luminal condition of trachea and bronchial tubes and other airways, which is crucial for lung surgery. 4. Tumor markers of lung cancer: squamous cell carcinoma antigen (SCC), carcinoembryonic antigen (CEA), cytokeratin 19 fragment (CyFRA21-1), neuron-specific enolase (NSE) have a certain auxiliary effect on diagnosis. 5. Examination of sputum: for those with lung infection, sputum bacterial culture and drug sensitivity test can help to find the infected bacteria and effective antibiotics for targeted anti-infection treatment; sputum cytology can also be carried out, and some lung cancer patients can find shed cancer cells in sputum, so as to determine the diagnosis. Determine whether there is distant metastasis 1. Abdominal ultrasound and CT: Liver, retroperitoneum, kidney and adrenal gland are common metastatic sites of lung cancer, so abdominal ultrasound or CT is needed to determine whether there is abdominal metastasis. 2. Head CT: In recent years, due to the common application of head CT examination for lung cancer patients, many asymptomatic patients with brain metastasis have been found, which wins time for treatment, and simple brain metastasis can be staged surgery with good effect. Bone scan: bone is also a common metastatic site of lung cancer, and bone isotope scan can find the bones with lesions. Determine how each organ (especially heart and lungs) functions 1. Cardiopulmonary function examination: cardiopulmonary function is an important assessment content before surgery, which is of great value to the formulation of surgical methods and the evaluation of postoperative pulmonary function recovery. It includes electrocardiogram, pulmonary function test, arterial blood gas analysis, cardiac ultrasound, long range electrocardiogram and other tests. 2.Blood test: blood routine, blood biochemistry, coagulation function, blood transfusion set, blood type, etc. can understand the patient’s general condition, prepare for the surgery and improve the safety of the surgery. 3, other tests, when combined with chronic diseases, such as diabetes, heart disease, hypertension and liver, kidney disease, should further improve the relevant examination. The fundamental purpose of preoperative auxiliary examination is to assess the patient’s condition, formulate individualized treatment plan according to the patient’s own situation, and actively treat the patient for a complete cure.