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We reported on a 66-year-old male who developed a severe obstruction of a portion of the intermedistinal trachea as a result of tracheostomy and endotracheal intubation following surgery for hepatoma. He had the endotracheal intubation for 42 days. After the tracheal hole closed, he had no respiratory symptoms for about 2 months. He complained of difficulty in breathing, and his symptoms progressed rapidly. Endoscopy revealed endotracheal stenosis, with the narrowest part being 3-4mm in diameter. The stenotic portion was in the intermediastinal space. During open mediastinal surgery, an annular excision was performed, three tracheal cartilages were cut and an end-to-end anastomosis was performed. As intubation through the stenotic part was impossible, the incubate tube was kept just above the oral side of the stenotic portion, and, during the operation, anesthetic control was maintained under spontaneous respiration. The postoperative couse was satisfactory, and the patient could stand up 20 days after the operation

Annular Excision and End-to-End Anastomosis of Intermediastinal Tube-Tip Stenosis.