本研究回顾性分析了2015年3月至2019年6月浙江大学医学院附属第二医院收治的3例肾铸型结石合并肾盂癌患者的病例资料，男2例，女1例。年龄52~81岁。既往均有腔镜碎石术史。3例术前检查发现肾盂或肾盂输尿管连接处可疑占位。3例均行腹腔镜肾盂切开取石术，术中切取占位组织活检，分别确诊为肾盂中-低分化鳞癌、浸润性尿路上皮癌、肾盂中分化鳞癌，均行腹腔镜根治性肾输尿管切除术。3例术后随访16~48个月，1例术后16个月出现腹膜后淋巴结转移，2例术后分别随访3年和4年未见复发转移。复杂性肾铸型结石合并肾盂癌容易出现漏诊，选择性采用腹腔镜肾盂切开取石术联合切取法术中活检，能有效提高活检确诊率，是避免漏诊、实现诊疗一体的新型微创手术方式。“,”Three cases of renal pelvic neoplasm associated with staghorn calculi were enrolled to the study from March 2015 to June 2019. All patients underwent minimally invasive procedures previously including extracorporeal shock wave lithotripsy (ESWL), flexible ureteroscopic lithotripsy(FURL), or percutaneous nephrolithotripsy (PCNL). 3 patients of renal pelvic neoplasm with giant staghorn calculus were diagnosed by resection biopsy during laparoscopic pyelolithotomy intraoperatively and then treated by laparoscopic radical nephroureterectomy (LRNU). Case 1 was identified retroperitoneal lymph node metastasis 16 months after operation. Case 2 and 3 remained disease free. The timely diagnosis of renal pelvic neoplasm associated with staghorn calculi is always difficult, nevertheless, the laparoscopic pyelolithotomy with resection biopsy intraoperatively can be more effective in selected cases compared with routine endoscopic biopsy.