Abstract: Objective　To explore the effect of thin vascularized lymph node transfer (VLNT) combined with reverse mapping in the treatment of secondary upper extremity lymphedema. Methods　From July 2019 to September 2020, the free vascularized inguinal lymph node thin-layered flap was prepared by the reverse mapping guided by indocyanine green and methylene blue double staining, which was excised and transplant to the upper limb of the affected side to treat 5 patients with secondary lymphedema after the operation of breast cancer. The flap was about 10 cm×5 cm in size and 0.7 cm in thickness. About 2 to 3 lymph nodes in the donor area were excised. The patients were followed up for 7 to 15 months. Results　All the flaps survived well and all lymph nodes survived. In postoperative follow-up, the circumference of the affected limb was significantly reduced 1.5 months later, and the donor area had no complications. Conclusion　Thin VLNT combined with reverse mapping in the treatment of secondary upper extremity lymphedema has good efficacy and aesthetic effect.

Key words: Thin vascularized lymph node transfer, 　Lymphedema, 　Indocyanine green, 　Reverse mapping, 　Breast cancer