To enhance the efficiency of extrapleural thoracoplasty in patients with fibrocavernous tuberculosis, the authors propose that the oper-ation should be supplemented by cavern ligation, thus inducing a more significant irreversible collapse only in the cavernous area. The above procedure has been used to operate on 164 subjects with the caverns being located in the upper lobe or the upper lobe and sixth segment of one lung. Decay cavity closure was achieved in 110 (67.1%) patients; bacterial excretion cessation was seen in 77 (76.2%) of 101 patients with 3.1% mortality. Long-term results were observed in 135 subjects. Clinical resolution was stated in 113 (83.7%) patients; 9 (6.7%) subjects died from progressive tuberculosis or postoperative complications. Analysis of the results of the proposed operation ascertained that its efficiency is little related to cavern sizes and noticeably decreases during a progressive tuberculous process.