大型（≥20毫米）结直肠侧向发育型肿瘤（LST）是结直肠癌（CRC）的直接前驱病变。关于如何最佳处理这些病变以预防复发、最终癌变以及转移、发病和死亡，存在着多种被认为分歧明显的范式。此类病变的处理已取得显著进展，包括新型切除技术、西方世界整块切除方法的采用日益增多以及培训的改善。然而，对于大型非有蒂结直肠息肉的处理仍缺乏明确共识，东方与西方范式之间存在显著的地域差异。围绕培训要求、染色内镜的使用、分片切除适宜病变的选择以及恰当随访的观点仍存在争议，缺乏全球统一的系统化方法。两位介入内镜专家代表世界内镜组织结直肠癌筛查委员会牵头开展了一项基于证据的德尔菲研究，以推动形成国际共识，更好地指导处理并试图统一实践。
Large colorectal laterally spreading tumors (LSTs) ≥20 mm are immediate precursors to colorectal cancer (CRC). There are many perceived diverging paradigms on the optimal management of these lesions to prevent recurrence, eventual development of cancer, and metastasis, morbidity, and mortality. There have been significant advances in the management of these lesions, with novel resection techniques, increased uptake of en bloc resection methods in the Western world, and improved training. There is, however, a lack of clear consensus on the management of large nonpedunculated colorectal polyps, with significant geographic variability between Eastern and Western paradigms. Opinions surrounding training requirements, the use of chromoendoscopy, the selection of appropriate lesions for piecemeal resection, and appropriate follow-up remain controversial with a lack of a unified worldwide systematic approach. Two experts in interventional endoscopy spearheaded an evidence-based Delphi study on behalf of the World Endoscopy Organization Colorectal Cancer Screening Committee to spearhead an international consensus to better guide management and attempt to homogenize practices.