<b>COMMON PEDIATRIC SURGICAL CONDITIONS AND ASSOCIATED POSTOPERATIVE SURGICAL OUTCOMES: AN URBAN AND RURAL COMPARATIVE ASSESSMENT</b>

Objective: To compare the spectrum of common pediatric surgical conditions and associated postoperative outcomes between urban and rural healthcare settings. Methods: A comparative cross-sectional study was conducted over a 6-month period at a tertiary care hospital representing urban and rural populations. Children aged 0–14 years undergoing elective or emergency surgical procedures for common pediatric surgical conditions were included. Demographic, clinical, operative, and postoperative data were collected using a structured proforma. The primary outcome was the rate of postoperative complications within 30 days, including surgical site infection (SSI), respiratory complications, reoperation, prolonged hospital stay, and mortality. Statistical analysis was performed using chi-square tests, independent t-tests, and multivariable logistic regression to identify independent predictors of postoperative morbidity. A p-value < 0.05 was considered statistically significant. Results: Most patients were from urban areas (84%), while 16% resided in rural regions. The most common pediatric surgical condition was acute appendicitis (35%), followed by undescended testis (25%) and inguinal hernia (16%). Overall postoperative complications occurred in 20% of patients. Logistic regression analysis demonstrated that rural residence was associated with increased odds of postoperative complications (OR 1.42; 95% CI 0.40–4.97), but this association did not reach statistical significance (p = 0.59). Conclusion: Although minimal urban–rural disparities exist in pediatric surgical presentation patterns and postoperative outcomes, still, strengthening rural surgical infrastructure, improving referral pathways, enhancing perioperative infection control, and expanding pediatric surgical workforce capacity are essential to reducing inequities and improving child health outcomes in LMIC settings.