Comparison of Long-term and Perioperative Complications between Tunneled and Conventional Peripherally Inserted Central Catheters in Patients with Tumor: A Systematic Review and Meta-Analysis

Background: Peripherally inserted central catheters (PICC) is widely used for long-term venous access in cancer patients, but conventional PICC is associated with high rates of infection and other complications. Aim:To comprehensively compare the long-term postoperative complications and perioperative indicators between tunneled and conventional PICC in patients with tumor. Methods:Studies comparing tunneled and conventional PICC from five databases were included.Meta-analyses were conducted to calculate odds ratios (OR) or standardized mean differences (SMD) with 95% confidence intervals (CI).Subgroup and sensitivity analyses were also performed.Results: Twelve studies involving 5149 patients were included.Compared with conventional PICC, tunneled PICC significantly reduced the risks of postoperative infection (OR = 0.37, 95% CI: 0.27-0.51,p < 0.001), thrombosis (OR = 0.32, 95% CI: 0.22-0.47,p < 0.001), catheter dislodgement (OR = 0.50, 95% CI: 0.32-0.76,p = 0.001), unplanned extubation (OR = 0.45, 95% CI: 0.26-0.78,p = 0.004), and skin injury (OR = 0.69, 95% CI: 0.50-0.95,p = 0.02).In terms of perioperative indicators, tunneled PICC had a higher first puncture success rate (OR = 2.53, 95% CI: 1.27-5.07,p = 0.009) and lower 24-hour oozing risk (OR = 0.41, 95% CI: 0.31-0.53,p < 0.001).Subgroup analysis confirmed the stability of the infection-reducing effect.Conclusions: Tunneled PICC offers significant advantages in reducing complications and improving perioperative performance.These findings suggest that tunneled PICC may be a valuable option for cancer patients.However, given the off-label nature of this technique and the geographic limitations of the current evidence, the results should be interpreted with caution.