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.
Reference:Ren X, Liu H, Chen S, Han C, Li S, Zhang X. 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. J Hosp Infect. 2026 May 21:S0195-6701(26)00192-1. doi: 10.1016/j.jhin.2026.05.019. Epub ahead of print. PMID: 42173322.