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Juan Wang,1 Yu Wang,1 Nan Jia,1 Yunxia Zhang,1 Jin Zhou,2 Jing Bao,1 Runhong Ni,3 Wenqing Zuo,4 Yan Li,5 Zhiying Yang1 1Department of Hepatobiliary Surgery, General Surgery, China-Japan Friendship Hospital, Beijing, People’s Republic of China; 2Department of Cardiothoracic Surgery, China-Japan Friendship Hospital, Beijing, People’s Republic of China; 3Department of Gastrointestinal Surgery, General Surgery, China-Japan Friendship Hospital, Beijing, People’s Republic of China; 4Department of Colorectal Surgery, General Surgery, China-Japan Friendship Hospital, Beijing, People’s Republic of China; 5Department of Head and Neck Surgery, China-Japan Friendship Hospital, Beijing, People’s Republic of ChinaCorrespondence: Zhiying Yang, Department of Hepatobiliary Surgery, General Surgery, China-Japan Friendship Hospital, 2 East Yinghuayuan Street, Chaoyang District, Beijing, 100029, People’s Republic of China, Tel/Fax +86-10-8420 5054, Email yangzhy@aliyun.comPurpose: Enteral nutrition tolerance studies are mainly focused on critical care, while perioperative nursing research for cancer patients is relatively scattered. This study aims to develop an evidence-based management protocol for promoting tolerance to perioperative enteral nutrition (tube feeding) for cancer patients in general surgical wards, to provide a practical reference for nursing staff.Methods: The study used evidence-based methods. Domestic and international databases were searched for articles on perioperative enteral nutrition (tube feeding) in surgical oncology patients. An initial draft of a generalizable management protocol for enteral nutrition tolerance was formulated through evidence synthesis and research team discussion. Two rounds of Delphi consultation were subsequently conducted with experts in enteral nutrition.Results: A management protocol for perioperative enteral nutrition tolerance in surgical oncology patients was established. The protocol comprised 5 first-level, 12 second-level, and 28 third-level indicators. The expert authority coefficients (Cr) for the two Delphi rounds were 0.857 and 0.880, respectively. The Kendall’s concordance coefficients (W) were 0.215 and 0.257 (both P< 0.05), indicating significant consensus.Conclusion: The management protocol for tube-fed enteral nutrition tolerance in perioperative surgical oncology patients showed strong expert consensus and high authority indices. The protocol provides a robust evidence-based foundation for the management of enteral nutrition tolerance in this patient population.Keywords: enteral nutrition, tube feeding, tolerance management, feeding intolerance, perioperative cancer patients