Mobile drainage with high suction versus mobile drainage with low suction.

INTERVENTION: Following pulmonary lobectomy (lower or upper lobes) patients are randomly assigned (1:1) by sequentially numbered, opaque, and sealed envelopes to one of two groups. Participants receive either low external suction (–5 cm H2O) or high external suction (–20 cm H2O) via a size 24 French silicone chest drain connected to an electronic drainage device. All other postoperative care is the same in both groups. Treatment ends when the chest drains are removed. Both arms use a chest drainage removal algorithm; patients have to be well pain managed and mobilized. There is no upper limit on fluid output (providing it is serous and no chylous). Air leak is < 20 ml/min with no spikes for 6 hours or < 50 ml/min with no spikes for 12 hours. Participants are followed up in the outpatient clinic two weeks after discharge from hospital. CONDITION: Pulmonary lobectomy ; Surgery ; Pulmonary lobectomy PRIMARY OUTCOME: Duration of air leakage is measured using the time of end of surgery and the time when the chest drain was removed (information from electronic patient charts). SECONDARY OUTCOME: 1. Fluid output is measured by recording measurements from the drainage device cannister on the patient chart.; 2. Length of stay is recorded from hospital records.; 3. Re‐insertion of chest drains (complications) is recorded using the information from the patient chart. INCLUSION CRITERIA: 1. Admitted for lobectomy (by thoracotomy or video‐assisted thoracoscopic surgery [VATS] as decided by the surgeon) 2. Aged over 18 years 3. Ability to give informed consent