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Background and objective Atelectasis is a common complication after thoracotomy, and it may threaten patients’ life if it was not treated correctly and properly. The aim of this article is to explore and discuss the prevention and treatment for atelectasis during the perioperative period, and also to explore new methods for reducing the perioperative mortality due to atelectasis after thoracotomy. Methods We retrospectively reviewed the medical records of 374 lung cancer patients who underwent thoracotomy in our department between Jan 2007 and Nov 2009. Results Atelectasis occurred in 14 patients among all the 374 lung cancer patients who underwent thoracotomy. All the atelectasis returned to reexpansion after treatment. Conclusion The incidence of atelectasis in these series is relatively low compared with the reports in literatures. Good perioperative preparation and perioperative treatment can remarkably decrease the incidence and mortality of atelectasis after thoracotomy in the treatment of lung cancer.