title: Sunitinib reduces recurrent pelvic adhesions in a rabbit model.
abstract: BACKGROUND
  Adhesions represent a major problem after abdominal and pelvic procedures. The purpose of the present study was to determine the effect of sunitinib (Sutent, SU11248), a Food and Drug Administration-approved receptor tyrosine kinase inhibitor, on recurrent pelvic adhesion formation after pelvic adhesiolysis in a rabbit model.
  
  
  METHODS
  A total of 20 New Zealand white rabbits underwent a uterine abrasion procedure, followed by an adhesiolysis procedure 4 weeks later. Before adhesiolysis, the rabbits were randomized to sunitinib at 10 mg/kg/d or placebo. These were administered as 1 dose preoperatively followed by 10 doses postoperatively. The rabbits were killed 30 d after the adhesiolysis procedure. At death, the adhesions were scored, and a total adhesion score (presented as the median and interquartile range [IQR]) was calculated according to the percentage of uterine involvement and the tenacity of the adhesions.
  
  
  RESULTS
  All the rabbits survived the operative procedures without complications. The sunitinib-treated rabbits (n = 10) had a significantly lower uterine involvement score (median 2.0, IQR 1.0-3.0) than the placebo-treated rabbits (median 4.0, IQR 3.0-4.0; P = 0.02). The sunitinib-treated rabbits also had median tenacity score of 3.0 (IQR 3.0-4.0) compared with a median of 4.0 (IQR 4.0-4.0; P = 0.04) in the placebo-treated rabbits (n = 10). The median total score in the sunitinib-treated rabbits was 5.0 (IQR 4.0-6.25) compared with 8.0 (IQR 6.75, 8.0) in the placebo-treated rabbits (P = 0.01).
  
  
  CONCLUSIONS
  Sunitinib treatment might be an efficacious strategy to reduce recurrent adhesion formation after pelvic procedures.
authors.affiliation: Department of Surgery and Vascular Biology Program, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts 02115, USA.
authors.forename: Erica M
authors.initials: EM
authors.lastname: Fallon
authors.forename: Deepika
authors.initials: D
authors.lastname: Nehra
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Carlson
authors.forename: Alexis K
authors.initials: AK
authors.lastname: Potemkin
authors.forename: Paul D
authors.initials: PD
authors.lastname: Mitchell
authors.forename: Arthur P
authors.initials: AP
authors.lastname: Nedder
authors.forename: Bo R
authors.initials: BR
authors.lastname: Rueda
authors.forename: Mark
authors.initials: M
authors.lastname: Puder
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D005260:Female; D007211:Indoles / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000517:prevention & control; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use*; D011758:Pyrroles / Q000627:therapeutic use*; D011817:Rabbits; D012008:Recurrence; D000077210:Sunitinib; D000267:Tissue Adhesions / Q000517:prevention & control*; D014599:Uterus / Q000601:surgery*
chemical_list: D007211:Indoles; D047428:Protein Kinase Inhibitors; D011758:Pyrroles; D000077210:Sunitinib