Abstract: Objective To assess the feasibility and safety of thoracoscopic bulla resection under laryngeal mask anesthesia with
low tidal volume high-frequency lung ventilation. Methods Sixty patients with pulmonary bulla were randomized into two
groups (n=30) to undergo video-assisted thoracoscopic surgery (VATS) for bulla resection with laryngeal mask anesthesia and
high-frequency low tidal volume lung ventilation general anesthesia and or with intubation anesthesia and one-lung
ventilation through double-lumen endotracheal intubation. Results No significant differences were found in anesthesia time,
surgery time, intraoperative lowest SpO2, intraoperative highest PetCO2, operative field, anesthetic effects, or blood loss
between the two groups. The post-operative WBC and NEU% showed significantly smaller increments in the mask anesthesia
group than in the intubation group, and the postoperative awake time, initial eating time, ambulation time, in-hospital stay,
and drainage time were significantly shortened in the former group with also lower incidences of gastrointestinal reactions,
throat discomfort and hoarseness. Conclusion Thoracoscopic bulla resection under laryngeal mask anesthesia with low tidal
volume high-frequency lung ventilation is safe and feasible and results in better patient satisfaction and shorter in-hospital
stay than procedures performed under intubation anesthesia with one-lung ventilation.