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The authors describe an improved method of percutaneous nephropyelostomy using a long, fine, flexible needle combined with a wider and shorter cannula. The needle facilitates atraumatic puncture of the renal collecting system and antegrade pyelography and subsequently serves as a guide over which the nephrostomy cannula is inserted. This technique was successful in 105 of 115 procedures (93 patients) over a period of 15 months and has replaced operative nephrostomy in the author's hospital.
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