Surgical treatment of recurrent tracheal papilloma: long-term follow-up study. The objective of this study was to evaluate the indications for reoperation for recurrent tracheal papilloma in a single center in Japan. From 1965 to 2012, 30 patients with recurrent tracheal papilloma were operated on in our hospital. Nineteen of these patients were male (63%) and 11 were female (37%), with a mean age of 49 years. The recurrent tracheal papilloma was removed from the same patient. The surgical technique, postoperative complications, and outcomes were evaluated in this retrospective study. Follow-up was completed in all patients, with a mean follow-up time of 6.4 years. During the follow-up, the tumor relapsed in 13 patients (48%) within 10 years after surgical treatment for the first time. The patients' age at recurrence ranged from 29 to 75 years with a mean of 48 years. The recurrent tracheal papilloma were located at the same location as the primary tumor in 11 patients (39%) and were different locations in 15 patients (52%). The recurrent tumor originated from the upper trachea in 8 patients (24%), from the middle trachea in 14 patients (45%), and from the lower trachea in 9 patients (29%). Local tracheal resection with primary anastomosis was performed in 15 patients (52%), local tracheal resection with end-to-end anastomosis in 5 patients (17%), and tracheal sleeve resection with end-to-end anastomosis in 7 patients (23%). The main postoperative complications were hoarseness (23%) and hypopharyngeal edema (7%). The long-term follow-up study of recurrent tracheal papilloma showed that most recurrences of tracheal papilloma occurred within 10 years after surgical treatment. Local tracheal resection with primary anastomosis can be an effective option for treatment of recurrent tracheal papilloma. Tracheal sleeve resection with end-to-end anastomosis should be avoided. The presence of recurrent lesions in different locations or involving different segments suggests multiple papillomatosis. To prevent an earlier recurrence of a tracheal papilloma, a long-term follow-up of a patient after endoscopic removal of a tracheal papilloma is important.