Pulmonary function tests (PFTs) continue to play a role in traditional preoperative evaluation of patients undergoing major surgeries, also enable the physician to follow the progression, of the impairment and to document the response to therapy. Thoracic surgery should focus on the extent and severity of pulmonary disease and cardiovascular involvement, developing postoperative complications. Smoking increases airway irritability, decreases mucociliary transport. It also decreases forced vital capacity (FVC), intraoperative management focus on monitoring, one-lung ventilation and fluid management. The strategy for postoperative analgesia should be developed and discussed with the patient.