 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. 