Clinical Research Projects

Projects Currently Available for Student Researchers:

Mentor: Lee Trombetta, MD, FACS
Department: General Surgery
Subject: Inpatient use of intravenous proton pump inhibitors for gastric ulcer prophylaxis , with focus on indications and cost in the context of post-operative diet advancement.

Mentor: Lee Trombetta, MD, FACS
Department: General Surgery
Subject: Predictive factors for re-admission after major colorectal surgery at a community level hospital

Mentor: Lee Trombetta, MD, FACS
Department: General Surgery
Subject: Use of blood cultures in the inpatient management of post-operative fever and leukocytosis with attention towards risk factors for bacteremia.

Current/Past Research Projects:

Student: Kasey Buchheit
School: Winona State University
Mentor: Lee Trombetta, MD, FACS & Matt Broghammer, DO
Department: General Surgery
Status: Ongoing
Subject: Comparison of Helicobacter Pylori positivity and cost-effectiveness with five test methods.

Analysis of rats of Helicobacter Pylori detection using fecal antigen testing, serologic antibody testing, urease ager, standard H & E histology, and immunohistochemistry. All patient undergoing endoscopic biopsy of the gastric antrum as well as those undergoing noninvasive testing were included. A 2-year study interval is being analyzed, with over 600 patients. Goals of the study are to determine the most accurate and cost-effective test method, with focus on standardizing institutional clinical diagnostic pathways.

Student: Adam Goodrick
School: Creighton University
Mentor: Lee Trombetta, MD, FACS
Department: General Surgery
Status: Complete
Subject: Liver Biopsy is Indicated During Laparoscopic Cholecystectomy for Patients with Preoperative Imaging Evidence of Fatty Liver

Comparative analysis of liver biopsies performed during cholecystectomy in patients with fatty liver disease seen on pre-operative ultrasound and CT scan. Identified risk factors for severe disease based on patient characteristic and pre-operative liver function serology. Study included 252 patients over a 2-year period.

Published:
“Liver Biopsy is Indicated During Laparoscopic Cholecystectomy for Patients with Preoperative Imaging Evidence of Fatty Liver”
Gundersen Medical Journal, Volume 8 Issue 2; October 2014
Leroy J. Trombetta, MD, FACS; Barbara Bennie, PhD; Adam Goodrick; Ronald G. England, DO; Matthew J. Broghammer, DO; Hans M. Zinnecker, MD, FACS

Student: Hayley Hudson
School: University of Wisconsin-Lacrosse
Mentor: Lee Trombetta, MD, FACS
Department: General Surgery
Status: Complete
Subject: Preoperative deep venous thrombosis and thromboembolism chemoprophylaxis in colorectal surgery patients.

Five-year review of enoxaparin (Lovenox) administration in patients undergoing elective colorectal surgery for both benign and malignant indications. Study included ### patients. Findings were presented at biannual Cancer Committee meeting as an ACS-mandated quality assurance initiative, prompting a systemic change in pre-operative DVT prophylaxis pathways.

Student: Taylor Hanson
School: St. Mary’s University
Mentor: Lee Trombetta, MD, FACS & Karen Perkins PA-C
Department: General Surgery
Status: Complete
Subject: Impact of bilateral breast MRI in the surgical decision making process in patients with breast cancer.

Five-year analysis of all breast cancer patients with focus on rates of breast conservation therapy versus mastectomy. Study included 148 patients. Rates of concomitant BIRAD 3 or higher MRI-detected lesions, repeat biopsy, and synchronous multifocal or contralateral cancers were determined. Data was presented at the biannual Cancer Committee meeting and used as ACS-mandated quality assurance initiative.

Student: Kallie Hart
School: Winona State University
Mentor: Lee Trombetta, MD, FACS & Karen Perkins, PA-C
Department: General Surgery
Status: Complete
Subject: Rates of pathologic positive tumor margins in breast conservation therapy and impact on salvage mastectomy.

Five year retrospective analysis of all patients undergoing breast conservation therapy for invasive breast cancer and carcinoma in-situ. Pathologic tumor margin was recorded and positivity rates determined. For patients with positive margins, subsequent rates of re-excision lumpectomy versus mastectomy were determined. Winona Health results were also compared with patients primariluy managed at outside institution. The study included 48 patients. Data was presented at the biannual Cancer Committee meeting and used as ACS-mandated quality assurance initiative.

Student: Jack Kielty
School: Winona State University
Mentor: Lee Trombetta, MD, FACS & Matt Broghammer, DO
Department: General Surgery
Status: Ongoing
Subject: Colonoscopic adenomatous polyp detection rates in rural surgical endoscopic practice.

Analysis of rates of polyp detection during colonoscopies performed at Winona Health, with focus on comparison to national bench mark rates and determination of unique patient predictors.

Student: Chelsea Ritter
School: Winona State University
Mentor: Jennifer Bayer
Department: Conservative Management Clinic
Status: Ongoing
Subject: Role of Yoga in the management of chronic back pain.

Exploring the role of a standardized Yoga protocol in the treatment strategy for patients with chronic low back pain. Study in conjunction with the University of Iowa.

Student: Kyle Williams
School: Winona State University
Mentor: Hans Serleth, MD
Department: Plastic Surgery
Status: Ongoing
Subject: Thickness of mastectomy skin flap: intraoperative caliper measurement versus pre-operative digital mammographic measurement.

Comparison of predicted mastectomy flap thickness as measured on pre-operative digital mammography to intra-operative direct caliper measurement. Implications on tissue perfusion and operative outcomes.

Student: Jenna Lenell
School: Winona State University
Mentor: Lee Trombetta, MD, FACS, Bethany Corliss da Rocha, MD
Department: Continuous Clinical Improvement Committee
Status: Ongoing
Subject: Comprehensive management of appendicitis from presentation to discharge. Development of an interdepartmental management protocol for appendicitis with focus on resource management, duration of hospital stay, and patient outcomes.

Student: George Hudson
School: Post Graduate work
Mentor: Lee Trombetta, MD, FACS, Shanu Kotari, MD
Department: General Surgery
Status: Ongoing
Subject: Long term management strategy in patients with biopsy proven nonalcoholic steatosis (fatty liver disease).

Collaborative project with Gundersen Lutheran examining the clinical relevance of non-alcoholic hepatic steatosis with focus on choice of intervention, compliance, and long-term follow-up.

Student: Jenna Goodwin
Mentor: Katrina Hammel, MD
Department: Inpatient Internal Medicine
Status: Ongoing
Subject: Critical examination of the role of associate level providers on an inpatient hospitalist service, with focus on responsibilities, work distribution, and physician oversight.

Student: Katelyn Cummings
Mentor:
Rebecca Lossen, MD
Department: Urgent Care
Status: Ongoing
Subject: Lack of primary care physician assignment in patients presenting to Urgent Care – analysis of patterns and reasons why patients in the Winona community choose not to have a primary care doctor.

Student: Isabel Irazoque
Mentor:
Angie Johannes, RN
Department: Surgery
Status: Ongoing
Subject: Infection control measures in the operating room with attention to advanced pre-operative skin preparation protocol.

Student: Lakni Jayasinghe
Mentor:
Lee Trombetta, MD, FACS
Department: General Surgery
Status: Ongoing
Subject: Prospective analysis of opiod requirements in opiod-dependent chronic pain patients managed in a novel dedicated medication management clinic.

Student: Kristen Hagle
School: Winona State University
Mentor: Lee Trombetta, MD, FACS & Matt Broghammer, DO
Department: General Surgery
Status: Ongoing
Subject: Benefits of laparoscopic preperitoneal hernia repair at a community hospital.

Analysis of demographic features, post-operative pain and return to work in patients undergoing laparoscopic preperitoneal inguinal hernia repair compared to open hinguinal ernia repair.

Student: Kyle Coon
School: Winona State University
Mentor: Brett Whyte, MD
Department: Emergency Medicine
Status: Ongoing
Subject: Nurse-only UTI protocols in the Urgent Care Setting.

Analysis of nurse-only diagnosis and treatment protocols for urinary tract infections with regards to outcomes, patient satisfaction and resource utilization.

Student: Joseph Haire
Mentor: Lee Trombetta, MD, FACS
Department: General Surgery
Status: Protocol Development Phase
Subject: Use of scheduled screening urine toxicology in opiod-dependent chronic pain patients with focus on determining predictors for synchronous illicit drug use.

Student: Spencer Treu
Mentor: Lee Trombetta, MD, FACS
Department: General Surgery
Status: Protocol Development Phase
Subject: Cognitive testing in patients undergoing chemotherapy and the potential impact of a treatment intervention

Student: Anne Krueger
Mentor: Angie Johannes, RN
Department: Operating Room Services
Status: Ongoing
Subject: Deep venous thrombosis rates in joint replacement surgery and the development of standardized perioperative prophylactic chemoprevention protocol

For more information:

Lori Stanislawski
Executive Assistant, Administrative Office
507.457.4483
lstanislawski@winonahealth.org

Winona Health
855 Mankato Avenue
Winona, MN 55987

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