Open drainage of the pleural cavity — thoracostomy we regard as an extreme forced measure, the use of which is justified only in rare cases of the ineffectiveness of other methods of surgical and conservative treatment of patients. In surgery lung indications torakostomii cancer arise mostly after palliative pneumonectomy to form large inconsistency bronchial stump or trachea seams when inconsistency seams resected during surgery esophageal wall with the development empyema flowing with severe purulent intoxication and inability to achieve an effective readjustment pleural cavity method of closed drainage. The second indication for open management of the pleural cavity, which occurs less frequently in lung cancer,is an extensive suppuration of the thoracotomic wound with a significant divergence of its edges and the development of pleural empyema with severe intoxication. The thoracostomy, in some cases, allows to achieve fast detoxification and effective sanation of pleural empyema and, thereby, save the lives of patients. However, mortality among patients with lung cancer who underwent thoracostomy reached 30%. Death, as a rule, occurred from the progression of purulent intoxication, arrosive bleeding, pulmonary thromboembolism, generalization of the tumor process.

While observing the above approaches and the technique of performing extended combined resections of the lungs, we practically did not observe complications in the postoperative period associated with resections of the muscle membrane of the esophageal wall, diaphragm, and pericardium. Therefore, we believe that patients who have undergone such operations do not need to apply additional methods of local treatment.

Treatment of patients undergoing advanced combined resection of the lung, especially in the immediate and early postoperative periods, is a complex therapeutic and diagnostic process, requiring the concerted participation of both resuscitators and surgeons in it. The success of treatment of operated patients is largely determined by a rational and targeted combination of methods of general and local therapy.