Cavernoplasty for pulmonary tuberculosis is a local surgical technique that aims to lead the cavity to an appropriate state of healing by means of incision, curettage of the caseous materials in the cavity and its primary closure.<BR>Reviewed here are 78 cases surgically treated during the period from January, 1965, to the end of the March, 1977. Their results are discussed and types of cases for which the procedure is not indicated are noted. The cases have been divided into 5 groups according to the classification of severity for surgical treatment by the Tuberculosis Research Committee, Ryoken, as follows: non-severe 18, mild 26, moderately 21 and highly and above 13.<BR>Since 1971, the method has been positively applied in cases where lobectomy had been formerly considered the recommended procedure. This is the reason why the number of operations on non-severe and mildly severe patients has been increased rescently.<BR>Good results were obtained in 60 cases without postoperative complications. Eighteen cases including three late postoperative deaths showed postoperative complications, namely the persistence of positive bacilli, the re-opening of cavity or insufficient closure of the dead space in thorax. However, good results were finally obtained in 10 out of these 18 cases.<BR>Our experience indicates that the main causes of operative failures are nadequate pneu molysis or insufficient postoperative re-expansion of the lung in cases with low lung compliance, because the healing of the lesion is attained not only by local mechanical curettage, but also through the compression of the surrounding lung tissue. The latter is the most important factor in achieving the desired results in cavernoplasty and is an essential difference between cavernoplasty and another local surgical procedure, cavernostomy.<BR>In cases where good results have been obtained, ibrocicatrization is observed on the site of the operation and this has been confirmed histologically in a specimen accidentally obtained. The method is a local procedure, so postoperative lung function is hardly injured.<BR>Due to remarkable advances in antituberculous drugs, most tuberculosis patients can be controlled by chemotherapy alone, and surgery is thought to be playing a supplementary role. As a local surgical procedure, cavernoplasty is recommended as one of the leading contemporary methods, well-suited for this purpose.<BR>But, because of the healing mechanism mentioned above, there are some cases in which cavernoplasty should not be used. For example, it is not indicated for cases with low lung compliance or for cases difficult to separate the pleural adhesion. Cavernostomy is recommended for these cases.