OBJECTIVE The aim of this study is to assess the role of the pleural tent in prophylactics of prolonged alveolar air leakage and apical residual pleural cavity formation after upper lobectomy/bilobectomy. METHODS A total of 40 patients, who underwent upper lobectomy/bilobectomy were prospectively randomized into two homogeneous groups: (1) with pleural tent--20 pts and (2) control group without pleural tent--20 pts. The multivariate analyses were used to compare the chest tubes duration, the length of the hospital stay, the mean quantity of postoperative extravasation and the need of additional interventions to treat the persistent postoperative alveolar leak. RESULTS No differences were detected between the two groups in terms of preoperative and operative characteristics. No 30-day operative death was faced. A significant reduction (p=0.001) of the number of days the chest tubes were required (7.7 days vs 12.38 days) and the length of the postoperative in-hospital stay (9.7 days vs 13.75 days) was found in pleural tent group compared to control group. The mean quantity of postoperative extravasation in pleural tent group was less compared to control group (1553 ml vs 1722 ml) without statistical significance (p=0.5485). Asymptomatic residual apical pleural cavities were found in 1 patient of pleural tent group and 2 patients of control group. In other 3 patients of the latter group an additional tube drainage was required to treat a residual apical cavity. CONCLUSIONS Pleural tenting after upper lobectomy/bilobectomy reduces significantly the duration of the intrapleural drainages and the length of the in-hospital stay. It is simple, safe and effective additional method in the prophylactics of persistent alveolar air leakage and apical residual pleural cavity formation.