OBJECTIVE: To probe into the effects of early sequential application of different formulations of enteral nutrition on nutrition

gastrointestinal function

rehabilitation process and inflammatory mediators in patients undergoing radical resection of rectal cancer. METHODS: According to the randomized envelope method and the principle of 1∶ 1 trial design

88 patients undergoing radical resection of colorectal cancer from Jan. 2020 to Jan. 2022 were divided into the control group（44 cases

given whole protein enteral nutrition）

the sequential group（44 cases

sequential application of amino acid-based

short peptide and whole protein-based enteral nutrition）. Nutritional indicators [body weight

prealbumin（PA）

total protein（TP） and serum albumin（ALB）]

gastrointestinal function indicators [serum growth inhibition（SS）

gastrin（GAS）

vasoactive intestinal peptide（VIP） and gastrin（MTL）]

anal evacuation time

feeding time

first defecation time

first time out of bed

length of stay

inflammatory mediators [tumor necrosis factor alpha（TNF-α）

interleukin（IL） 6

IL-1

C-reactive protein（CRP） and IL-8] and complications of two groups were compared. RESULTS: After surgery of 7 d

the body weight

PA

TP and ALB levels of two groups were lower than those before surgery

yet the sequential group was higher than the control group

the differences were statistically significant（P<0.05）. After surgery of 7 d

the SS level of sequential group was lower than that of control group

the GAS

VIP and MTL levels were higher than those of control group

and the anal evacuation time

feeding time

first defecation time

first time out of bed

length of stay were shorter than those of control group

the differences were statistically significant（P<0.05）. After surgery of 7 d

the TNF-α

IL-6

IL-1

CRP and IL-8 levels in two groups were higher than those before surgery

yet the sequential group was lower than the control group

the differences were statistically significant（P<0.05）. The total incidence of complications in the sequential group was 4.55%（2/44）

compared with 11.36%（5/44） in the control group

the difference was not statistically significant（P>0.05）. CONCLUSIONS: The routine application of different preparations of enteral nutrition in the early stage can improve the nutritional status

gastrointestinal motility and inflammatory response of patients with radical rectal cancer

promote the recovery of gastrointestinal function

and speed up the recovery process of patients

which is safe and reliable.