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It is widely accepted by most thoracic surgeons that a complete control on fluid and air in the pleural space could only be maintained by conventional closed chest drainage (two chest tubes). With the development of medical models and devices in pneumonectomy, the validity of this concept is being questioned. In this review, we summarized that: the current situation and problems of closed chest drainage; the advantage and disadvantage of water seal with or without suction on chest drainage; and the advances and contradiction of single chest tube drainage after pneumonectomy.