ObjectiveTo investigate the application effect of digital chest drainage system in patients with air leak after lung resection and evaluate its efficacy and safety. MethodsClinical data of patients who underwent lung resection and received closed thoracic drainage postoperatively in the Department of Thoracic Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University from January 2024 to November 2025 were collected. Patients with air leak graded Ⅰ to Ⅲ were divided into an experimental group (digital chest drainage system) and a control group (traditional closed thoracic drainage) according to different drainage devices used. Baseline characteristics and perioperative data were retrospectively analyzed and compared between the two groups. ResultsA total of 170 patients were included, with 81 in the experimental group (59 males, 22 females; median age 68 years) and 89 in the control group (60 males, 29 females; median age 68 years). There were no statistically significant differences between the two groups in terms of age, gender, body mass index, surgical type, pleural adhesions, surgical site, lesion nature, comorbidities, smoking index, or air leak grade (P>0.05). The experimental group had significantly less median total drainage volume [490 (883) mL vs. 740 (958) mL, P=0.023], shorter air leak duration [5 (2) d vs. 5 (4) d, P=0.005] and postoperative hospital stay [5 (1) d vs. 6 (4) d, P=0.029]. However, there were no statistically significant differences in hospitalization costs or drainage volume within the first 7 postoperative days between the two groups (P>0.05). The incidence of subcutaneous emphysema was significantly lower in the experimental group (27.16% vs. 41.57%, P=0.049). No significant differences were found between the groups in the incidence of pulmonary infection, atelectasis, pleural effusion, skin incision issues, secondary tube placement, or pain scores (P>0.05). Subgroup analysis revealed that for patients with grade Ⅰ air leak, the experimental group showed shorter air leak duration [5 (2) d vs. 5 (5) d, P=0.006] and postoperative hospital stay [5 (2) d vs. 6 (4) d, P=0.010] compared to the control group, with no significant difference in total drainage volume (P=0.055). For patients with grade Ⅱ air leak, there were no significant differences in total drainage volume, air leak duration, or postoperative hospital stay between the two groups (P>0.05). For patients undergoing wedge resection, the experimental group had less total drainage volume [289 (707) mL vs. 880 (1074) mL, P=0.035] compared to the control group, while no significant differences were found in air leak duration or postoperative hospital stay (P>0.05). For patients undergoing segmentectomy, there were no significant differences in total drainage volume, air leak duration, or postoperative hospital stay between the two groups (P>0.05). For patients undergoing lobectomy, the experimental group had shorter air leak duration [5 (2) d vs. 6 (4) d, P=0.029] compared to the control group, while no significant differences were found in total drainage volume or postoperative hospital stay (P>0.05). ConclusionCompared with traditional closed thoracic drainage, the digital chest drainage system effectively shortens the duration of postoperative air leak and hospital stay, reduces total drainage volume, and lowers the incidence of subcutaneous emphysema without increasing total hospitalization costs. It is a safe and effective drainage method for pulmonary resection patients, particularly those with grade Ⅰ air leak following lobectomy.