Abstract Background Chest drain suction of ?20?cm H2O has been used universally after lung resection. After introducing new guidelines,?8?cm H2O was used routinely for all non‐pneumonectomy, thoracoscopic lung resections. We conducted a review to determine outcomes and safety. Methods After introduction of the guidelines data were collected in the study institutions' thoracic surgical database and subsequently analysed. Results A total of 155 patients underwent thoracoscopic lung resection. Mean patient age was 61.5?±?13.6?years. Video‐assisted thoracoscopic surgery was performed in 92.2 (144/155) of patients and robotically‐assisted thoracoscopic surgery was performed in 7.8 (12/155) of patients. Lobectomy was performed in 56.8 (88/155) of patients, segmentectomy was performed in 11.6 (18/155) of patients and wedge resection was performed in 31.6 (49/155) of patients. Median ICC duration time was 1?day (IQR 1–3). Median length of stay was 3?days (IQR 2–6). For patients undergoing lobectomy median ICC time was 2?days (IQR 1–4.5) and median length of stay was 3.5?days (IQR 2–7), for segmentectomy median ICC time was 1?day (IQR 1–5) and median length of stay was 2?days (IQR 1–5) and for wedge resection median ICC time was 1?day (IQR 1–1) and median admission time was 2?days (IQR 1–4). Conclusion A suction level ?8?cm H2O is safe to use for thoracoscopic lung resections from day 0 post‐operatively. A dedicated, prospective study comparing levels of suction should be performed.
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