Study of Postoperative Chest Tube Management

This study is a prospective, multi-center randomized clinical trial at 6 sites. Pre-operative
evaluation and the decision for surgical intervention will proceed as currently performed at
each center. That is, neither inclusion in nor exclusion from this study will affect the plan
of care for patients other than the approach to chest tube management, which is determined by
randomization among 4 methods that are in common clinical use. Each enrolled patient will be
randomized to either regulated pleural pressure using the Thopaz+ digital chest drainage
device or unregulated pleural pressure using a traditional system (multi-chambered system
e.g. Pleur-Evac, Atrium-Maquet or similar device as is routine at each institution) and also
randomized to either active suction (-20 cm H2O) or passive drainage.

Inclusion Criteria:

- Able and willing to read, understand, and provide written consent

- Age 18-90

- Undergoing a segmentectomy, lobectomy, or bilobectomy (including sleeve resection).
Both open and minimally invasive (thoracoscopic or robotic) resections are acceptable

Exclusion Criteria:

- Patients unstable enough to require ICU care for hemodynamic or respiratory problems
during the first 7 days postoperatively. Patients admitted to the ICU for other
reasons (e.g. bed availability, institutional norm, routine monitoring etc.) should
NOT be excluded

- Patients undergoing non-anatomic lung resection only (i.e. wedge resection)

- Patients undergoing anatomic lung resection for bullous disease, lung abscess or
bronchiectasis.

- Patients undergoing pneumonectomy or completion pneumonectomy