Applicability of TIVAP versus PICC in non-hematological malignancies patients: A meta-analysis and systematic review

BACKGROUND: Applicability of totally implantable venous access port (TIVAP) and peripherally inserted central venous catheter (PICC) in non-hematological malignancies patients remains controversial. METHODS: A systematic studies search in the public databases PubMed, EMBASE, Wan Fang, CNKI (China National Knowledge Infrastructure), the Cochrane Library and Google Scholar (updated to May 1, 2020) was performed to identify eligible researches. All statistical tests in this meta-analysis were performed using Stata 12.0 software (Stata Corp, College Station, TX). A P value less than 0.05 was considered statistically significant. RESULTS: Thirteen studies were included in this final meta-analysis. The pooled data showed that compared with PICC, TIVAP was associated with a higher first-puncture success rate (OR:2.028, 95%CI:1.25–3.289, P<0.05), a lower accidental removal rate (OR:0.447, 95%CI:0.225–0.889, P<0.05) and lower complication rates, including infection (OR:0.570, 95%CI: 0.383–0.850, P<0.05), occlusion (OR:0.172, 95%CI:0.092–0.324, P<0.05), malposition (OR:0.279, 95%CI:0.128–0.608, P<0.05), thrombosis (OR:0.191, 95%CI, 0.111–0.329, P<0.05), phlebitis (OR:0.102, 95%CI, 0.038–0.273, P<0.05), allergy (OR:0.155, 95%CI:0.035–0.696, P<0.05). However, no difference was found in catheter life span (P>0.05) and extravasation (P>0.05). Moreover, TIVAP is more expensive compared with PICC in six-month use (weighted mean difference:3.132, 95%CI:2.434–3.83, P<0.05), but is much similar in 12 months use (P>0.05). CONCLUSION: For the patients with non-hematological malignancies, TIVAP was superior to PICC in the data related to placement and the incidence of complications. Meanwhile, TIVAP is more expensive compared with PICC in six-month use, but it is much similar in twelve-month use.